Provider Demographics
NPI:1881879872
Name:MILES, PETER JAMES (RPH)
Entity type:Individual
Prefix:
First Name:PETER
Middle Name:JAMES
Last Name:MILES
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:HILTON
Mailing Address - State:NY
Mailing Address - Zip Code:14468-1211
Mailing Address - Country:US
Mailing Address - Phone:585-392-7979
Mailing Address - Fax:585-392-2256
Practice Address - Street 1:32 MAIN ST
Practice Address - Street 2:
Practice Address - City:HILTON
Practice Address - State:NY
Practice Address - Zip Code:14468-1211
Practice Address - Country:US
Practice Address - Phone:585-392-7979
Practice Address - Fax:585-392-2256
Is Sole Proprietor?:No
Enumeration Date:2008-01-08
Last Update Date:2008-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY042962183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist