Provider Demographics
NPI:1275576696
Name:MILLER, DANIEL R (MD)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:R
Last Name:MILLER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1250 WATERS PL
Mailing Address - Street 2:SUITE 1206
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10461-2720
Mailing Address - Country:US
Mailing Address - Phone:718-409-5454
Mailing Address - Fax:718-409-0857
Practice Address - Street 1:1250 WATERS PL
Practice Address - Street 2:SUITE 1206
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10461-2720
Practice Address - Country:US
Practice Address - Phone:718-409-5454
Practice Address - Fax:718-409-0857
Is Sole Proprietor?:No
Enumeration Date:2006-06-14
Last Update Date:2023-10-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY155156207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00958934Medicaid
75D671Medicare ID - Type Unspecified
A64156Medicare UPIN