Provider Demographics
NPI:1912195231
Name:MILLIANO, ANTHONY JOSEPH SR (AUD)
Entity Type:Individual
Prefix:
First Name:ANTHONY
Middle Name:JOSEPH
Last Name:MILLIANO
Suffix:SR
Gender:M
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 BRETT CHASE
Mailing Address - Street 2:SUITE B
Mailing Address - City:PADUCAH
Mailing Address - State:KY
Mailing Address - Zip Code:42003-5706
Mailing Address - Country:US
Mailing Address - Phone:270-554-6000
Mailing Address - Fax:270-554-6995
Practice Address - Street 1:150 BRETT CHASE
Practice Address - Street 2:SUITE B
Practice Address - City:PADUCAH
Practice Address - State:KY
Practice Address - Zip Code:42003-5706
Practice Address - Country:US
Practice Address - Phone:270-554-6000
Practice Address - Fax:270-554-6995
Is Sole Proprietor?:No
Enumeration Date:2007-10-11
Last Update Date:2007-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYKY0245237600000X
KYKY0632237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
No237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
4408277OtherAETNA
655374OtherHEALTHLINK
KY000000326458OtherANTHEM
KY70002456Medicaid
4408277OtherAETNA
655374OtherHEALTHLINK