Provider Demographics
NPI:1235584442
Name:MILLER, PILAR (LPN)
Entity Type:Individual
Prefix:
First Name:PILAR
Middle Name:
Last Name:MILLER
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13 CHESTNUT ST
Mailing Address - Street 2:FLOOR 2
Mailing Address - City:GLEN COVE
Mailing Address - State:NY
Mailing Address - Zip Code:11542-1915
Mailing Address - Country:US
Mailing Address - Phone:516-303-2545
Mailing Address - Fax:
Practice Address - Street 1:13 CHESTNUT ST
Practice Address - Street 2:FLOOR 2
Practice Address - City:GLEN COVE
Practice Address - State:NY
Practice Address - Zip Code:11542-1915
Practice Address - Country:US
Practice Address - Phone:516-303-2545
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-26
Last Update Date:2016-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY324872164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse