Organization
RICARDO A. MILLER NURSE PRACTITIONER IN PSYCHIATRY, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RICARDO MILLER (OWNER)
(516) 568-7032
Entity
Organization
Contact information
Practice address
115 S CORONA AVE, VALLEY STREAM, NY 11580-6217
(516) 568-7032
Mailing address
115 S CORONA AVE, VALLEY STREAM, NY 11580-6217
(516) 568-7032
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02866306
—
NY
Enumeration date
05/24/2021
Last updated
05/24/2021
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