Provider Demographics
NPI:1427380518
Name:MILLER, LAURA ANNE (RPH)
Entity Type:Individual
Prefix:MS
First Name:LAURA
Middle Name:ANNE
Last Name:MILLER
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45 KITTLEBERGER PARK APT A
Mailing Address - Street 2:
Mailing Address - City:WEBSTER
Mailing Address - State:NY
Mailing Address - Zip Code:14580-3189
Mailing Address - Country:US
Mailing Address - Phone:518-569-8886
Mailing Address - Fax:
Practice Address - Street 1:1125 RIDGE RD
Practice Address - Street 2:
Practice Address - City:WEBSTER
Practice Address - State:NY
Practice Address - Zip Code:14580-2909
Practice Address - Country:US
Practice Address - Phone:585-872-0690
Practice Address - Fax:585-872-0722
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-01
Last Update Date:2022-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY042248183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist