Individual
CLIFTON WAYNE MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1645 SAINT PAUL ST, ROCHESTER, NY 14621-3162
(910) 783-9062
Mailing address
1645 SAINT PAUL ST, ROCHESTER, NY 14621-3162
(910) 783-9062
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
858976812
NY STATE ID
NY
Enumeration date
02/12/2020
Last updated
02/12/2020
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