Provider Demographics
NPI:1780647081
Name:MILLER, KENNETH SCOTT (MD)
Entity Type:Individual
Prefix:DR
First Name:KENNETH
Middle Name:SCOTT
Last Name:MILLER
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Gender:M
Credentials:MD
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Mailing Address - Street 1:MILLER OPHTHALMOLOGY ASSOCIATES, LLC 16 SOUTH JEFFERS
Mailing Address - Street 2:FIR 2
Mailing Address - City:WHIPPANY
Mailing Address - State:NJ
Mailing Address - Zip Code:07981-1047
Mailing Address - Country:US
Mailing Address - Phone:973-325-3300
Mailing Address - Fax:973-325-3320
Practice Address - Street 1:MILLER OPHTHALMOLOGY ASSOCIATES, LLC 16 SOUTH JEFFERS
Practice Address - Street 2:FIR 2
Practice Address - City:WHIPPANY
Practice Address - State:NJ
Practice Address - Zip Code:07981-1047
Practice Address - Country:US
Practice Address - Phone:973-325-3300
Practice Address - Fax:973-325-3320
Is Sole Proprietor?:No
Enumeration Date:2006-04-08
Last Update Date:2022-10-14
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA06247900207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJG19617Medicare UPIN
NJ787179-MENMedicare PIN