Provider Demographics
NPI:1912285610
Name:MILLER, IRIS MAUREEN (OD)
Entity Type:Individual
Prefix:
First Name:IRIS
Middle Name:MAUREEN
Last Name:MILLER
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:IRIS
Other - Middle Name:MAUREEN
Other - Last Name:RAFFERTY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:400 BALD HILL RD
Mailing Address - Street 2:SUITE 504, WARWICK MED BLDG
Mailing Address - City:WARWICK
Mailing Address - State:RI
Mailing Address - Zip Code:02886
Mailing Address - Country:US
Mailing Address - Phone:401-463-3500
Mailing Address - Fax:
Practice Address - Street 1:300 TOLL GATE RD
Practice Address - Street 2:SUITE 101B
Practice Address - City:WARWICK
Practice Address - State:RI
Practice Address - Zip Code:02886-4416
Practice Address - Country:US
Practice Address - Phone:401-463-3500
Practice Address - Fax:401-739-9670
Is Sole Proprietor?:No
Enumeration Date:2011-07-28
Last Update Date:2016-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIODTG00560152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist