National Provider Identifier

Portland Orthopaedic Associates LLC

Portland Orthopaedic Associates LLC is listed in the NPPES registry with a primary specialty of Orthopaedic Surgery Physician in Rochester, NY and a listed phone number of (585) 266-3300.

NPI 1629185756Rochester, NYOrthopaedic Surgery Physician

Profile Overview

NPI
1629185756
Provider Type
Organization
Primary Specialty
Orthopaedic Surgery Physician
Enumeration Date
August 24, 2006
Last Updated
August 22, 2020

Practice Location

  • 1299 Portland Avenue
  • Suite 16
  • Rochester, NY 14621

Phone: (585) 266-3300

Specialties

  • Orthopaedic Surgery Physician (207X00000X)
Full Record
NPI
1629185756
Entity Type
Organization
EIN
<UNAVAIL>
Organization Name
Portland Orthopaedic Associates LLC
Mailing Street Address
1299 Portland Avenue
Mailing Address Line 2
Suite 16
Mailing City
Rochester
Mailing State
NY
Mailing ZIP Code
14621
Mailing Country
US
Mailing Phone
(585) 266-3300
Mailing Fax
(585) 266-2163
Practice Street Address
1299 Portland Avenue
Practice Address Line 2
Suite 16
Practice City
Rochester
Practice State
NY
Practice ZIP Code
14621
Practice Country
US
Practice Phone
(585) 266-3300
Practice Fax
(585) 266-2163
Enumeration Date
August 24, 2006
Last Updated
August 22, 2020
Authorized Official Last Name
Niles
Authorized Official First Name
Michael
Authorized Official Middle Name
A
Authorized Official Title
Solo Practitioner
Authorized Official Phone
(585) 266-3300
Organization Subpart
No
Authorized Official Credential Text
MD
Taxonomy Group 1
193200000X Multi-Specialty Group
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Orthopaedic Surgery Physician (207X00000X)
Other Identifiers
01430097 (NY), 0181311590 (NY, Excellos), 102371CU (NY, Preferred Care)