Provider Information for 1922004845
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WENDY A MILLER MD
Sex: Female
NPI: 1922004845
Last Updated: 2022-09-29
Certification Date:
Certification Date:
Details
Name | Value | ||||||||||||||
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NPI | 1922004845 | ||||||||||||||
Enumeration Date | 2005-06-24 | ||||||||||||||
NPI Type | NPI-1 Individual | ||||||||||||||
Sole Proprietor | NO | ||||||||||||||
Status | Active | ||||||||||||||
Mailing Address | 263 FARMINGTON AVE PROVIDER ENROLLMENT FARMINGTON, CT 06030-2212 United States Phone: 860-679-7503 | Fax:860-679-1610 | ||||||||||||||
Primary Practice Address | 263 FARMINGTON AVE FARMINGTON, CT 06030-0001 United States Phone: 860-679-4477 | Fax:860-679-4474 | ||||||||||||||
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