Provider Demographics
NPI:1629128384
Name:MILLER, LEWIS P (MD)
Entity Type:Individual
Prefix:DR
First Name:LEWIS
Middle Name:P
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 1:210 E 68TH ST APT 9E
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021-6021
Mailing Address - Country:US
Mailing Address - Phone:212-628-9057
Mailing Address - Fax:212-628-9057
Practice Address - Street 1:210 E 68TH ST APT 9E
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-6021
Practice Address - Country:US
Practice Address - Phone:212-628-9057
Practice Address - Fax:212-628-9057
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY142563207P00000X
NJ54528207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine