Individual
BETHANY LUCIANI MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
80 NORWICH NEW LONDON TPKE, UNCASVILLE, CT 06382-2527
(860) 848-1297
(860) 848-9875
Mailing address
80 NORWICH NEW LONDON TPKE, UNCASVILLE, CT 06382-2527
(860) 848-1297
(860) 848-9875
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
1434
CT
363A00000X
Physician Assistant
Primary
001434
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
290001434CT01
ANTHEM/ECCG:06-1049086
—
01
—
2V5290
HEALTHNET/ECCG:06-1049086
—
01
—
2V5291
HEALTHNET/ECCD:06-1616101
—
01
—
625224
CONNECTICARE
—
01
—
P3495612
OXFORD/ECCG: 06-1049086
—
01
—
P3617313
OXFORD/ECCD: 06-1616101
—
Enumeration date
06/12/2006
Last updated
11/20/2013
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