Basic Information
| Provider Information | |||||||||
| NPI: | 1487899480 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MILLER | ||||||||
| FirstName: | ADINA | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | ROTHBERGER | ||||||||
| OtherFirstName: | ADINA | ||||||||
| OtherMiddleName: | |||||||||
| OtherNamePrefix: | DR. | ||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | MD | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 375 ENGLE ST | ||||||||
| Address2: | SECOND FLOOR | ||||||||
| City: | ENGLEWOOD | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 076311823 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2018716073 | ||||||||
| FaxNumber: | 2016556159 | ||||||||
| Practice Location | |||||||||
| Address1: | 350 ENGLE ST | ||||||||
| Address2: | |||||||||
| City: | ENGLEWOOD | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 076311808 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2018716073 | ||||||||
| FaxNumber: | 2016556159 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/05/2008 | ||||||||
| LastUpdateDate: | 10/24/2012 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | |||||||||
| AuthorizedOfficialTelephone: | |||||||||
| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | 25MA09125400 | NJ | Y | Allopathic & Osteopathic Physicians | Anesthesiology |
No ID Information.