Connelly Dominick Miller

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

101 Nicolls Road
Department of Urology Health Sciences Center, T-9 Room
Stony Brook, NY 11794-8093

Phone

(631) 444-1916

NPI assigned

Mar 18, 2022

Sex

Male

Sole proprietor

No

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)

Not enrolled

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

{
    "created_epoch": "1647561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647561600000",
    "number": "1316696388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 NICOLLS RD DEPT OF",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117948093",
            "telephone_number": "631-444-1916"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 NICOLLS ROAD",
            "address_2": "DEPARTMENT OF UROLOGY HEALTH SCIENCES CENTER, T-9 ROOM",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117948093",
            "telephone_number": "631-444-1916"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "CONNELLY",
        "middle_name": "DOMINICK",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-03-18",
        "last_updated": "2022-03-18",
        "certification_date": "2022-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Charles Bazemore Mikell III, M.D.
• Meridith Mikulich, MPH, CNM, RN
• Carolyn Milana, M.D.
• Jessica Sara Miller Mantell, D.O
• Charla Miller, DO
• Eleanor S Miller, P.A.
• Emily Kathleen Hogan Miller, M.D.
• Eric Jonathan Miller, MD
• Jennifer Eve Miller, M.S CCC-SLP
• Laurence H Miller, MSED

• Student in an Organized Health Care Education/Training Program in Stony Brook, NY
• Providers in Stony Brook, NY by specialty
• Student in an Organized Health Care Education/Training Program in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 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.