Provider Demographics
NPI:1598118309
Name:MILMAN, CREDAHINA (NURSE PRACTITIONER)
Entity Type:Individual
Prefix:MS
First Name:CREDAHINA
Middle Name:
Last Name:MILMAN
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:140 W 62ND ST # G16
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10023-7407
Mailing Address - Country:US
Mailing Address - Phone:212-636-7160
Mailing Address - Fax:
Practice Address - Street 1:140 W 62ND ST # G16
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10023-7407
Practice Address - Country:US
Practice Address - Phone:212-636-7160
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-16
Last Update Date:2016-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY307827363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health