Provider Demographics
NPI:1275672735
Name:MILLER, NAOMI (PHD ACSW)
Entity Type:Individual
Prefix:DR
First Name:NAOMI
Middle Name:
Last Name:MILLER
Suffix:
Gender:F
Credentials:PHD ACSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:140 RIVERSIDE DRIVE
Mailing Address - Street 2:SUITE 1 0
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10024-3605
Mailing Address - Country:US
Mailing Address - Phone:212-296-9766
Mailing Address - Fax:917-441-0214
Practice Address - Street 1:140 RIVERSIDE DRIVE
Practice Address - Street 2:SUITE 1 0
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10024-3605
Practice Address - Country:US
Practice Address - Phone:212-296-9766
Practice Address - Fax:917-441-0214
Is Sole Proprietor?:No
Enumeration Date:2007-02-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0034701041C0700X
NYPR0183231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
N00681Medicare ID - Type Unspecified