Provider Demographics
NPI:1831257740
Name:MILLER, PATRICIA POLANIK (PHD)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:POLANIK
Last Name:MILLER
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Gender:F
Credentials:PHD
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Mailing Address - Street 1:1A PINE WEST PLZ
Mailing Address - Street 2:PINE BUSH MENTAL HEALTH, LLP
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12205-5556
Mailing Address - Country:US
Mailing Address - Phone:518-862-1665
Mailing Address - Fax:518-862-1668
Practice Address - Street 1:1A PINE WEST PLZ
Practice Address - Street 2:PINE BUSH MENTAL HEALTH, LLP
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12205-5556
Practice Address - Country:US
Practice Address - Phone:518-862-1665
Practice Address - Fax:518-862-1668
Is Sole Proprietor?:No
Enumeration Date:2006-12-04
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
NY014323103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical