Provider Demographics
NPI:1902228430
Name:MILLER, ERIK G (SLP)
Entity Type:Individual
Prefix:MR
First Name:ERIK
Middle Name:G
Last Name:MILLER
Suffix:
Gender:M
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:305 COLLEGE AVE
Mailing Address - Street 2:
Mailing Address - City:ELMIRA
Mailing Address - State:NY
Mailing Address - Zip Code:14901-2705
Mailing Address - Country:US
Mailing Address - Phone:607-734-1861
Mailing Address - Fax:607-734-1985
Practice Address - Street 1:305 COLLEGE AVE
Practice Address - Street 2:
Practice Address - City:ELMIRA
Practice Address - State:NY
Practice Address - Zip Code:14901-2705
Practice Address - Country:US
Practice Address - Phone:607-734-1861
Practice Address - Fax:607-734-1985
Is Sole Proprietor?:No
Enumeration Date:2014-01-17
Last Update Date:2014-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000355-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist