Provider Demographics
NPI:1871647644
Name:BARBARA J. MILLER, M.D., P.C.
Entity Type:Organization
Organization Name:BARBARA J. MILLER, M.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:J
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:315-472-8721
Mailing Address - Street 1:5800 HERITAGE LANDING DR
Mailing Address - Street 2:SUITE E
Mailing Address - City:EAST SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13057-9378
Mailing Address - Country:US
Mailing Address - Phone:315-472-8721
Mailing Address - Fax:315-472-2513
Practice Address - Street 1:5800 HERITAGE LANDING DR
Practice Address - Street 2:SUITE E
Practice Address - City:EAST SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13057-9378
Practice Address - Country:US
Practice Address - Phone:315-472-8721
Practice Address - Fax:315-472-2513
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-22
Last Update Date:2008-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1050762084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00721953Medicaid
NY56253BMedicare ID - Type Unspecified
NY00721953Medicaid