Provider Demographics
NPI:1942656681
Name:GREGG MILLER NEW YORK CITY MEDICAL SERVICES PLLC
Entity type:Organization
Organization Name:GREGG MILLER NEW YORK CITY MEDICAL SERVICES PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CORPORATE VP
Authorized Official - Prefix:
Authorized Official - First Name:CARYL
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHARPF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-639-7185
Mailing Address - Street 1:1776 EASTCHESTER RD
Mailing Address - Street 2:SUITE 240
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10461-2341
Mailing Address - Country:US
Mailing Address - Phone:480-639-7185
Mailing Address - Fax:602-798-8267
Practice Address - Street 1:1776 EASTCHESTER RD
Practice Address - Street 2:SUITE 240
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10461-2341
Practice Address - Country:US
Practice Address - Phone:480-636-9718
Practice Address - Fax:602-798-8267
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-12
Last Update Date:2016-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY262874207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00001Medicare PIN