Basic Information
Provider Information
NPI: 1811263890
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MILLER
FirstName: ERIN
MiddleName: ELIZABETH
NamePrefix: DR.
NameSuffix:  
Credential: D.O.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 33-57 HARRISON ST
Address2: PERINATAL CENTER
City: JOHNSON CITY
State: NY
PostalCode: 137902107
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 33-57 HARRISON ST
Address2: PERINATAL CENTER
City: JOHNSON CITY
State: NY
PostalCode: 137902107
CountryCode: US
TelephoneNumber: 6077636101
FaxNumber: 6077635180
Other Information
ProviderEnumerationDate: 03/24/2012
LastUpdateDate: 07/14/2016
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207V00000X282552-1NYY Allopathic & Osteopathic PhysiciansObstetrics & Gynecology 

No ID Information.


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