Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208G00000X | Cardiothoracic Vascular Surgeon | 161824 | NY |
NPI | 1124013446 |
---|---|
Provider Name | Stuart J Miller |
First Address | Albany, NY 12208-3403 |
Second Address | Albany, NY 12208-3403 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/09/2005 |
Last Update Date | 24/02/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
011696999 | (05) | NY |
020053298 | RR MEDICARE (01) | NY |
1004482 | (05) | VT |
2014459 | (05) | MA |
C49876 | (02) |