Provider Demographics
NPI:1497301220
Name:MILLER OPHTHALMOLOGY ASSOCIATES LLC
Entity Type:Organization
Organization Name:MILLER OPHTHALMOLOGY ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:973-325-3300
Mailing Address - Street 1:101 OLD SHORT HILLS RD STE 430
Mailing Address - Street 2:
Mailing Address - City:WEST ORANGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07052-1023
Mailing Address - Country:US
Mailing Address - Phone:973-325-3300
Mailing Address - Fax:973-325-3320
Practice Address - Street 1:315 E NORTHFIELD RD STE 2B
Practice Address - Street 2:
Practice Address - City:LIVINGSTON
Practice Address - State:NJ
Practice Address - Zip Code:07039-4800
Practice Address - Country:US
Practice Address - Phone:973-994-0010
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MILLER OPHTHALMOLOGY ASSOCIATES, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-08-16
Last Update Date:2019-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier