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Organization

SHA-BOSS P

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. HANAN MILLER MD (OWNER)
(718) 377-7988
Entity
Organization

Contact information

Practice address
660 LOUISIANA AVE, BROOKLYN, NY 11239-1526
(718) 669-7100
Mailing address
3715 BEDFORD AVE, BROOKLYN, NY 11229-1703
(718) 377-7988

Taxonomy

Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary

Other

Enumeration date
07/25/2022
Last updated
07/25/2022
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