Individual
DR. JASON HARRIS MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
77 SCHANCK RD # 55, SUITE B-3, FREEHOLD, NJ 07728-2964
(732) 462-9800
(732) 308-1647
Mailing address
77 SCHANCK RD # 55, SUITE B-3, FREEHOLD, NJ 07728-2964
(732) 462-9800
(732) 308-1647
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
25MA08560500
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
158106CVR
CMS-MEDICARE GROUP MEMBER PTAN
NJ
Enumeration date
02/18/2009
Last updated
09/01/2009
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