Individual
BRADLEY J MILLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
25 FAIRFIELD WAY APT 13, COMMACK, NY 11725-3414
(631) 885-5706
Mailing address
25 FAIRFIELD WAY APT 13, COMMACK, NY 11725-3414
(631) 885-5706
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
773825
NY
Other
Enumeration date
12/14/2020
Last updated
12/14/2020
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