# JOHN L. NILES MD, PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1144656364
- **Authorized official:** DR. JOHN L NILES M.D. (OWNER)
- **Authorized official phone:** (617) 726-4132

## Contact information

- **Practice address:** 101 MERRIMAC ST, 1ST FLOOR, BOSTON, MA 02114-4724
- **Practice address phone:** (617) 726-4132
- **Practice address fax:** (617) 726-4213
- **Mailing address:** 101 MERRIMAC ST, 1ST FLOOR, BOSTON, MA 02114-4724
- **Mailing address phone:** (617) 726-4132
- **Mailing address fax:** (617) 726-4213

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM2500X | Medical Specialty Clinic/Center | 54243 | MA | Yes |

## Other

- **Enumeration date:** 09/19/2013
- **Last updated:** 02/04/2015

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | AA399963 | HPHC | MA |