Miller, Kenneth
Miller, Kenneth is an individual health care provider with primary practice located at 62 S Fullerton Ave , Montclair NJ 07042-2629. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Cardiovascular Disease, Allopathic & Osteopathic Physicians / Interventional Cardiology. Allopathic & Osteopathic Physicians / Cardiovascular Disease is his primary health care specialty. Miller, Kenneth can be contacted via phone (973) 746-8585.Contact Information
Primary practice address
62 S Fullerton Ave
Montclair NJ 07042-2629
Phone: (973) 746-8585
Fax: (973) 746-0088
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 103421 | New Jersey |
| Allopathic & Osteopathic Physicians / Cardiovascular Disease | 207RC0000X | 103421 | New Jersey |
| Allopathic & Osteopathic Physicians / Interventional Cardiology | 207RI0011X | 103421 | New Jersey |
Profile Details
| NPI number | 1043212798 |
|---|---|
| LBN Legal business name | Miller, Kenneth |
| Credentials | MD FACC FSCAI |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 12th, 2005 |
| Last updated | Jan 6th, 2011 - about 14 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1043212798 | NPPES |
| New Jersey | Other | 742059B82 | MEDICARE ID TYPE UNSPECIFIED |
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