Organization
LAWRENCE C MILLER MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAWRENCE C MILLER M.D. (PRESIDENT)
(718) 816-8322
Entity
Organization
Contact information
Practice address
1430 CLOVE RD, STATEN ISLAND, NY 10301-4300
(718) 816-8322
(718) 816-8519
Mailing address
1430 CLOVE RD, STATEN ISLAND, NY 10301-4300
(718) 816-8322
(718) 816-8519
Taxonomy
Speciality
Code
Description
License number
State
2084P0015X
Psychosomatic Medicine Physician
Primary
80495
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00114916
—
NY
Enumeration date
05/30/2007
Last updated
08/22/2020
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