Organization
VA MEDICAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. STEFAN MILLER P.A. (PHYSICIAN ASSISTANT)
(631) 261-4400
Entity
Organization
Contact information
Practice address
VA MEDICAL CENTER, 79 MIDDLEVILLE RD - CARDIOLOGY 111, NORTHPORT, NY 11768
(631) 261-4400
Mailing address
50 SEQUOIA DR, CORAM, NY 11727-2039
(631) 474-0263
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
000277
NY
Other
Enumeration date
10/27/2006
Last updated
08/22/2020
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