Provider Demographics
NPI:1417055369
Name:MILLER, DAVID S (PA)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:S
Last Name:MILLER
Suffix:
Gender:M
Credentials:PA
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Mailing Address - Street 1:85 MARTHA RD
Mailing Address - Street 2:
Mailing Address - City:HARRINGTON PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07640-1852
Mailing Address - Country:US
Mailing Address - Phone:973-735-4864
Mailing Address - Fax:914-302-0060
Practice Address - Street 1:255 W SPRING VALLEY AVE
Practice Address - Street 2:SUITE 101
Practice Address - City:MAYWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07607
Practice Address - Country:US
Practice Address - Phone:973-429-6991
Practice Address - Fax:919-425-0478
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-21
Last Update Date:2023-10-17
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Provider Licenses
StateLicense IDTaxonomies
NJ25MP00168100363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant