Provider Demographics
NPI:1902865751
Name:COVER-MILLER, DENISE (OD)
Entity Type:Individual
Prefix:
First Name:DENISE
Middle Name:
Last Name:COVER-MILLER
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:219 MONTPELIER DR
Mailing Address - Street 2:
Mailing Address - City:DOWNINGTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19335-1287
Mailing Address - Country:US
Mailing Address - Phone:610-265-2020
Mailing Address - Fax:610-337-2348
Practice Address - Street 1:1111 SWEDESFORD RD
Practice Address - Street 2:
Practice Address - City:WAYNE
Practice Address - State:PA
Practice Address - Zip Code:19087
Practice Address - Country:US
Practice Address - Phone:610-265-2020
Practice Address - Fax:610-337-2348
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG001023152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAU64750Medicare UPIN
PA417640LU5Medicare ID - Type Unspecified