Provider Demographics
NPI:1871284448
Name:MILLER, DEBORAH ANN
Entity type:Individual
Prefix:
First Name:DEBORAH
Middle Name:ANN
Last Name:MILLER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6184 SWEETLAND RD
Mailing Address - Street 2:
Mailing Address - City:STAFFORD
Mailing Address - State:NY
Mailing Address - Zip Code:14143-9531
Mailing Address - Country:US
Mailing Address - Phone:585-356-5779
Mailing Address - Fax:
Practice Address - Street 1:153 PROSPECT ST
Practice Address - Street 2:
Practice Address - City:ATTICA
Practice Address - State:NY
Practice Address - Zip Code:14011-1149
Practice Address - Country:US
Practice Address - Phone:585-591-0945
Practice Address - Fax:585-591-3019
Is Sole Proprietor?:No
Enumeration Date:2023-05-16
Last Update Date:2023-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1686396183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician