Provider Demographics
NPI:1831285758
Name:MILLER, PHILIP J (MD, FACS)
Entity Type:Individual
Prefix:DR
First Name:PHILIP
Middle Name:J
Last Name:MILLER
Suffix:
Gender:M
Credentials:MD, FACS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:60 E 56TH ST
Mailing Address - Street 2:SUITE 300
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10022-3204
Mailing Address - Country:US
Mailing Address - Phone:212-750-7100
Mailing Address - Fax:212-750-7101
Practice Address - Street 1:60 E 56TH ST
Practice Address - Street 2:SUITE 300
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10022-3204
Practice Address - Country:US
Practice Address - Phone:212-750-7100
Practice Address - Fax:212-750-7101
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-05
Last Update Date:2014-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY182702086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYG07180Medicare UPIN