Doctor Name: | TIFFANY MARIE MILLER |
NPI Number: | 1043357080 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PA-C |
License Number: | AP 2017 |
Business Practice Address: | 170 Morton St Jamaica Plain, MA - 021303735 |
Business Phone Number: | 6179713452 |
Business Fax Number: | |
Mailing Address: | 87 Winchester St, Apt #4 BROOKLINE |
State: | MA |
Postal Code: | 024462771 |
Phone Number: | 4135304498 |
Fax Number: | |
NPI Enumeration Date: | 01/31/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AM0700X |
License Number: | AP 2017 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MA |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Medical |
Taxonomy Definition: |