Provider Demographics
NPI:1922199116
Name:MILLER, HEATHER (PT, DPT)
Entity Type:Individual
Prefix:DR
First Name:HEATHER
Middle Name:
Last Name:MILLER
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:70 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:ADAMS
Mailing Address - State:NY
Mailing Address - Zip Code:13605-3102
Mailing Address - Country:US
Mailing Address - Phone:315-232-2225
Mailing Address - Fax:315-232-2800
Practice Address - Street 1:70 N MAIN ST
Practice Address - Street 2:
Practice Address - City:ADAMS
Practice Address - State:NY
Practice Address - Zip Code:13605-3102
Practice Address - Country:US
Practice Address - Phone:315-232-2225
Practice Address - Fax:315-232-2800
Is Sole Proprietor?:No
Enumeration Date:2006-09-27
Last Update Date:2023-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0170201225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02412279Medicaid
NYDD6171Medicare PIN