Organization
PORTLAND PEDIATRIC GROUP, LLP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RODERICK G DAVIS M.D (PRESIDENT)
(585) 342-5694
Entity
Organization
Contact information
Practice address
1700 HUDSON AVE, ROCHESTER, NY 14617-5104
(585) 342-5694
(585) 342-2345
Mailing address
1700 HUDSON AVE, ROCHESTER, NY 14617-5104
(585) 342-5694
(585) 342-2345
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
207792
NY
Other
Enumeration date
05/02/2007
Last updated
08/31/2012
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