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| Type | Legal entity | [sources] | |||
|---|---|---|---|---|---|
| Name | MILLER JUSTIN · MILLER, JUSTIN | [sources] | |||
| Legal form | not available | [sources] | |||
| Country | United States | [sources] | |||
| ID Number | 00018518 | [sources] | |||
| NPI | 1952594921 | [sources] | |||
| Sector | PSYCH · Psychologist | [sources] | |||
| Status | not available | [sources] | |||
| Address | 616 DALE COURT WEST, RIVERVALE, NJ 07675 | [sources] | |||
| Last change | Last processed | First seen | |||
Medical providers deemed ineligible to participate in New York State's Medicaid program.
United States · OMIG
Medical providers disqualified from participating in New Jersey State's Medicaid program.
United States · OIFP
us-mednj-86f6bd45adc86bfa109d4c082bf8f47744810eb8 · us-medny-ec92755a2ec8060c870291c68bc0d0acca64eb5fFor experts: raw data explorer
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| Sanctions | |||||
|---|---|---|---|---|---|
| Country | Authority | Program | Start date | End date | |
| United States | New Jersey Office of the State Comptroller | - | |||
| Address | ||
|---|---|---|
| Full address | Country | |
| 616 DALE COURT WEST, RIVERVALE, NJ 07675 | United States | |
| United States | New York State Office of the Medicaid Inspector General | - | - |