Provider Demographics
NPI:1750432654
Name:MILLER, CAROL SUE II (RD,CDE,CDN)
Entity type:Individual
Prefix:MRS
First Name:CAROL
Middle Name:SUE
Last Name:MILLER
Suffix:II
Gender:F
Credentials:RD,CDE,CDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:67 DAMASCUS DR
Mailing Address - Street 2:
Mailing Address - City:GANSEVOORT
Mailing Address - State:NY
Mailing Address - Zip Code:12831-1454
Mailing Address - Country:US
Mailing Address - Phone:518-583-8372
Mailing Address - Fax:518-583-8367
Practice Address - Street 1:211 CHURCH ST
Practice Address - Street 2:
Practice Address - City:SARATOGA SPRINGS
Practice Address - State:NY
Practice Address - Zip Code:12866-1046
Practice Address - Country:US
Practice Address - Phone:518-583-8372
Practice Address - Fax:518-583-8367
Is Sole Proprietor?:No
Enumeration Date:2007-01-16
Last Update Date:2012-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered