Individual
DR. MARTIN G MILLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.P.M.
Contact information
Practice address
23 ATLANTIC AVE, FREEPORT, NY 11520-5103
(516) 867-0560
(516) 867-0561
Mailing address
88 HARMON ST, LONG BEACH, NY 11561-2712
(516) 889-7056
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
N003272
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0057760
GHI PROVIDER ID #
NY
05
—
00657525
—
NY
01
—
0880916
AETNA USHC PROVIDER ID #
NY
01
—
21214
VYTRA PROVIDER ID #
NY
01
—
4103190001
MEDICARE DMERC NSC #
NY
01
—
4405430
OXFORD PROVIDER ID #
NY
01
—
A08008182
DMERC SUBMITTER ID #
NY
Enumeration date
06/10/2005
Last updated
03/28/2008
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