Provider Demographics
NPI:1629098306
Name:MILLER, RICHARD KERMIT I (PHD)
Entity Type:Individual
Prefix:PROF
First Name:RICHARD
Middle Name:KERMIT
Last Name:MILLER
Suffix:I
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 ELMWOOD AVE
Mailing Address - Street 2:ROOM 5-7550 UNIVERSITY OF ROCHESTER MEDICAL CENTER
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14642-8668
Mailing Address - Country:US
Mailing Address - Phone:585-275-2520
Mailing Address - Fax:
Practice Address - Street 1:601 ELMWOOD AVE
Practice Address - Street 2:ROOM 5-7550 UNIVERSITY OF ROCHESTER MEDICAL CENTER
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14642-8668
Practice Address - Country:US
Practice Address - Phone:585-275-2520
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYMILLR2207ZP0105X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0105XAllopathic & Osteopathic PhysiciansPathologyClinical Pathology/Laboratory Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY207ZP0105XOtherCLINICAL LAB DIRECTOR
NY2083T0002XOtherMEDICAL TOXICOLOGIST