Search › New York › 363A00000X
Jacob Miller
NPI 1083308605 · on the registry since 2023 · sole proprietor
Practice
- Address
- 11050 Mt Belvedere Blvd
Fort Drum, NY 13602 - Phone
- (315) 772-2729
- Organisation at this address
- Bobbi Petranchuk
Inferred from a shared address, not stated in the registry.
- Clinicians at this address
- 108
Registry record
- Primary taxonomy
- 363A00000X
363A00000X
- Sex
- Male
- Record last updated
- 2025-08-25
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in New York