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Individual

ELEANOR S MILLER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
P.A.

Contact information

Practice address
2500 NESCONSET HWY BLDG 16, SUITE 63C, STONY BROOK, NY 11790-2555
(631) 444-6250
Mailing address
2500 NESCONSET HWY BLDG 16, SUITE 63C, STONY BROOK, NY 11790-2555
(631) 444-6250
(631) 444-6665

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
002188
NY
363A00000X
Physician Assistant
Primary
002188
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
P00282619
RAILROAD
Enumeration date
02/24/2006
Last updated
09/18/2008
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