Provider Demographics
NPI:1578724290
Name:MILLER, JANET M F (RPA-C)
Entity Type:Individual
Prefix:MRS
First Name:JANET
Middle Name:M F
Last Name:MILLER
Suffix:
Gender:F
Credentials:RPA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1013 W BEECH ST
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:NY
Mailing Address - Zip Code:11561-1203
Mailing Address - Country:US
Mailing Address - Phone:516-431-7600
Mailing Address - Fax:516-431-7691
Practice Address - Street 1:1013 W BEECH ST
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:NY
Practice Address - Zip Code:11561-1203
Practice Address - Country:US
Practice Address - Phone:516-431-7600
Practice Address - Fax:516-431-7691
Is Sole Proprietor?:No
Enumeration Date:2008-06-25
Last Update Date:2012-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY004486-1363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYU18069Medicare UPIN