Dale Robert Miller, PMNHP-BS

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

F403411 Issued in NY

Practice address

7 Hillside PL
Ilion, NY 13357-2109

Phone

(646) 858-1804

Fax

(315) 363-9286

NPI assigned

May 6, 2021

Last updated

Dec 27, 2022By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1620259200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672099200000",
    "number": "1174107130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17603 LONG RIDGE DR",
            "city": "MONTVERDE",
            "state": "FL",
            "postal_code": "347564011",
            "telephone_number": "315-601-3548",
            "fax_number": "315-363-9286"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7 HILLSIDE PL",
            "city": "ILION",
            "state": "NY",
            "postal_code": "133572109",
            "telephone_number": "646-858-1804",
            "fax_number": "315-363-9286"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "17603 Long Ridge Dr",
            "address_purpose": "LOCATION",
            "city": "Montverde",
            "state": "FL",
            "postal_code": "347564011",
            "country_code": "US",
            "telephone_number": "646-858-1804",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MILLER",
        "first_name": "DALE",
        "middle_name": "ROBERT",
        "credential": "PMNHP-BS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-05-06",
        "last_updated": "2022-12-27",
        "certification_date": "2022-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "F403411",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kayleigh Nicole Marosek, CLC
• Stephen D May, DDS
• Denise McVay, MPT
• Jennifer P Melnick, RN
• Kysha Messina, LPN
• Jonathan Mizgala, DNP, FNP-BC
• Mohawk Valley Counseling Service
• Mohawk Valley Nursing Home
• Sara Michael Moran
• Mosaic Health, Inc. (Valley Family Health Center)

• Psychiatric/Mental Health Nurse Practitioner in Ilion, NY
• Providers in Ilion, NY by specialty
• Psychiatric/Mental Health Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2022; 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.