Provider Demographics
NPI:1083260970
Name:MILLER, NOAH SOPHIE (RDN)
Entity Type:Individual
Prefix:
First Name:NOAH
Middle Name:SOPHIE
Last Name:MILLER
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:NOA
Other - Middle Name:
Other - Last Name:MILLER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RDN
Mailing Address - Street 1:15 NATURES WAY BSMT
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08701-4338
Mailing Address - Country:US
Mailing Address - Phone:732-994-5292
Mailing Address - Fax:
Practice Address - Street 1:56 STEVEN LN
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08701-1545
Practice Address - Country:US
Practice Address - Phone:732-288-4681
Practice Address - Fax:732-993-4925
Is Sole Proprietor?:No
Enumeration Date:2019-08-15
Last Update Date:2019-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered