Provider Demographics
NPI:1619034576
Name:MILLER, DENNIS K (MD)
Entity Type:Individual
Prefix:DR
First Name:DENNIS
Middle Name:K
Last Name:MILLER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:162 E 78TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10075-0406
Mailing Address - Country:US
Mailing Address - Phone:212-472-1237
Mailing Address - Fax:212-472-5190
Practice Address - Street 1:162 E 78TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10075-0406
Practice Address - Country:US
Practice Address - Phone:212-472-1237
Practice Address - Fax:212-472-5190
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-02
Last Update Date:2023-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY157745207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NP188OtherOXFORD
A65168Medicare UPIN
97D341Medicare PIN