Provider Demographics
NPI:1356301600
Name:MILLER, AIMEE J (OD)
Entity Type:Individual
Prefix:MRS
First Name:AIMEE
Middle Name:J
Last Name:MILLER
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 FOREST CREEK COURT
Mailing Address - Street 2:
Mailing Address - City:GRAND ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:14072
Mailing Address - Country:US
Mailing Address - Phone:716-773-4391
Mailing Address - Fax:
Practice Address - Street 1:4545 TRANSIT RD
Practice Address - Street 2:SEARS OPTICAL
Practice Address - City:WILLIAMSVILLE
Practice Address - State:NY
Practice Address - Zip Code:14221
Practice Address - Country:US
Practice Address - Phone:716-631-4284
Practice Address - Fax:716-635-9426
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-23
Last Update Date:2011-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYTUV0055831152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYJ400039935Medicare PIN