Doctor Name: | CLEMENTINE MILLER |
NPI Number: | 1013306455 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | ADULT NP |
License Number: | 307173 |
Business Practice Address: | 214 State St Schenectady, NY - 123051806 |
Business Phone Number: | 5186888611 |
Business Fax Number: | |
Mailing Address: | 3217 Phillip St, SCHENECTADY |
State: | NY |
Postal Code: | 123061420 |
Phone Number: | 6178385375 |
Fax Number: | |
NPI Enumeration Date: | 01/22/2015 |
NPI Last Update Date: | 01/29/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LA2200X |
License Number: | 307173 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Adult Health |
Taxonomy Definition: |