Provider Demographics
NPI:1437255189
Name:MILLER, BARBARA J (MD)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:J
Last Name:MILLER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5800 HERITAGE LANDING DR
Mailing Address - Street 2:SUITE E
Mailing Address - City:EAST SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13057-9378
Mailing Address - Country:US
Mailing Address - Phone:315-472-8721
Mailing Address - Fax:315-472-2513
Practice Address - Street 1:5800 HERITAGE LANDING DR
Practice Address - Street 2:SUITE E
Practice Address - City:EAST SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13057-9378
Practice Address - Country:US
Practice Address - Phone:315-472-8721
Practice Address - Fax:315-472-2513
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-16
Last Update Date:2008-03-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY1050762084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00721953Medicaid
NYC58985Medicare UPIN
NY56253AMedicare ID - Type Unspecified
NY56253BMedicare PIN