Provider Demographics
NPI:1538173679
Name:MILLER, SAKINAH (MD)
Entity type:Individual
Prefix:
First Name:SAKINAH
Middle Name:
Last Name:MILLER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:82 HOLLAND ST
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14605-2131
Mailing Address - Country:US
Mailing Address - Phone:585-423-2800
Mailing Address - Fax:585-423-2868
Practice Address - Street 1:82 HOLLAND ST
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14605-2131
Practice Address - Country:US
Practice Address - Phone:585-423-2800
Practice Address - Fax:585-423-2868
Is Sole Proprietor?:No
Enumeration Date:2006-07-27
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY226119208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY113593DLOtherPREFERRED CARE
NY226119Medicaid
NY226119Medicaid
NY16467AMedicare ID - Type UnspecifiedMEDICARE B GROUP
NYDD4372Medicare PIN