Provider Demographics
NPI:1982689741
Name:MILLER, SCOTT T (MD)
Entity Type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:T
Last Name:MILLER
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:450 CLARKSON AVE
Mailing Address - Street 2:BOX 49
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11203-2056
Mailing Address - Country:US
Mailing Address - Phone:718-270-2843
Mailing Address - Fax:718-270-1692
Practice Address - Street 1:450 CLARKSON AVE
Practice Address - Street 2:B4-333
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11203-2056
Practice Address - Country:US
Practice Address - Phone:718-270-4714
Practice Address - Fax:718-270-1985
Is Sole Proprietor?:No
Enumeration Date:2005-12-14
Last Update Date:2013-05-14
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Provider Licenses
StateLicense IDTaxonomies
NY134294-12080P0207X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0207XAllopathic & Osteopathic PhysiciansPediatricsPediatric Hematology-Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00669576Medicaid
NYC12238Medicare UPIN
NY85A821Medicare ID - Type Unspecified