Individual
MR. IRA MILLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
505 NORTHERN BLVD, GREAT NECK, NY 11021
(516) 466-6751
(516) 466-9360
Mailing address
505 NORTHERN BLVD, GREAT NECK, NY 11021
(516) 466-6751
(516) 466-9360
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
859
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00737884
—
NY
Enumeration date
09/19/2006
Last updated
07/08/2007
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