Mary Irene Miller, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

034922 Issued in CT

Practice address

One Pomperaug Office Park
Suite 104
Southbury, CT 06488

Phone

(203) 262-6900

Fax

(203) 262-6045

NPI assigned

Jul 13, 2006

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 6

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1063437820",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "ONE POMPERAUG OFFICE PARK",
            "address_2": "SUITE 104",
            "city": "SOUTHBURY",
            "state": "CT",
            "postal_code": "06488",
            "telephone_number": "203-262-6900",
            "fax_number": "203-262-6045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "ONE POMPERAUG OFFICE PARK",
            "address_2": "SUITE 104",
            "city": "SOUTHBURY",
            "state": "CT",
            "postal_code": "06488",
            "telephone_number": "203-262-6900",
            "fax_number": "203-262-6045"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "MARY",
        "middle_name": "IRENE",
        "name_prefix": "Miss",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CT",
            "license": "034922",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "LIP063",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH NET",
            "identifier": "OR4281",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CONCTCARE",
            "identifier": "03492Z",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "00134922CT07",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FAMILY PLAN",
            "identifier": "00134922501",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CARE",
            "identifier": "00134922501",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ira D Mickenberg, M.D.
• Alexis Noelle Mierek
• Jennifer Milano, LPC-A
• David E Miller, RPT
• Hillary Eve Miller, RD, CD-N
• Nancy Millian, PSYD
• Mindful Guidance and Counseling LLC
• Alexandra Mitchell, L.AC.
• Modern Vein Care of Connecticut LLC
• Debra J Molsick, PT

• Internal Medicine Physician in Southbury, CT
• Providers in Southbury, CT by specialty
• Internal Medicine Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.