Provider Demographics
NPI:1437235801
Name:MARK A MILLER AND ASSOCIATES INC
Entity Type:Organization
Organization Name:MARK A MILLER AND ASSOCIATES INC
Other - Org Name:MARK A MILLER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICIAL BOARD-DIRECTOR EDUCATION
Authorized Official - Prefix:MISS
Authorized Official - First Name:VERONICA
Authorized Official - Middle Name:
Authorized Official - Last Name:PIDCOCK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-330-5239
Mailing Address - Street 1:1 NESHAMINY INTERPLEX
Mailing Address - Street 2:STE 205
Mailing Address - City:TREVOSE
Mailing Address - State:PA
Mailing Address - Zip Code:19053-6969
Mailing Address - Country:US
Mailing Address - Phone:215-330-5239
Mailing Address - Fax:
Practice Address - Street 1:1 NESHAMINY INTERPLEX
Practice Address - Street 2:STE 205
Practice Address - City:TREVOSE
Practice Address - State:PA
Practice Address - Zip Code:19053-6969
Practice Address - Country:US
Practice Address - Phone:215-330-5239
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-28
Last Update Date:2017-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0731390001Medicare NSC