Provider Demographics
NPI:1467428169
Name:MILLER, DANIEL G (DC, DACNB)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:G
Last Name:MILLER
Suffix:
Gender:M
Credentials:DC, DACNB
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27 JENNISON AVE
Mailing Address - Street 2:
Mailing Address - City:JOHNSON CITY
Mailing Address - State:NY
Mailing Address - Zip Code:13790-2338
Mailing Address - Country:US
Mailing Address - Phone:607-729-0591
Mailing Address - Fax:607-729-0967
Practice Address - Street 1:27 JENNISON AVE
Practice Address - Street 2:
Practice Address - City:JOHNSON CITY
Practice Address - State:NY
Practice Address - Zip Code:13790-2338
Practice Address - Country:US
Practice Address - Phone:607-729-0591
Practice Address - Fax:607-729-0967
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-23
Last Update Date:2010-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY010110111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYRA0557Medicare ID - Type Unspecified
U85793Medicare UPIN