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:
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Health care specialties

SpecialtyCodeLicense #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 13 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1043212798 NPPES
New Jersey Other 742059B82 MEDICARE ID TYPE UNSPECIFIED

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