Provider Information for 1003040379
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STEPHANIE L MILLER
Sex: Female
NPI: 1003040379
Last Updated: 2011-07-27
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||||||
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| NPI | 1003040379 | ||||||||||||
| Enumeration Date | 2009-05-14 | ||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||
| Sole Proprietor | YES | ||||||||||||
| Status | Active | ||||||||||||
| Mailing Address | 359 BALLSTON AVE SARATOGA SPRINGS, NY 12866-4723 United States Phone: 518-587-8008 | Fax:518-587-8241 | ||||||||||||
| Primary Practice Address | 359 BALLSTON AVE SARATOGA SPRINGS, NY 12866-4723 United States Phone: 518-587-8008 | Fax:518-587-8241 | ||||||||||||
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