Provider Demographics
NPI:1801897392
Name:MILLER, HARRY S (MD)
Entity type:Individual
Prefix:DR
First Name:HARRY
Middle Name:S
Last Name:MILLER
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:532 MOE RD
Mailing Address - Street 2:
Mailing Address - City:CLIFTON PARK
Mailing Address - State:NY
Mailing Address - Zip Code:12065-3822
Mailing Address - Country:US
Mailing Address - Phone:518-383-2425
Mailing Address - Fax:518-383-3255
Practice Address - Street 1:532 MOE RD
Practice Address - Street 2:
Practice Address - City:CLIFTON PARK
Practice Address - State:NY
Practice Address - Zip Code:12065-3822
Practice Address - Country:US
Practice Address - Phone:518-383-2425
Practice Address - Fax:518-383-3255
Is Sole Proprietor?:No
Enumeration Date:2005-08-09
Last Update Date:2025-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY182956208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01355619Medicaid
NY01355619Medicaid
NYDD1243Medicare ID - Type Unspecified