Organization
PORTLAND ORTHOPAEDIC ASSOCIATES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL A NILES MD (SOLO PRACTITIONER)
(585) 266-3300
Entity
Organization
Contact information
Practice address
1299 PORTLAND AVENUE, SUITE 16, ROCHESTER, NY 14621
(585) 266-3300
(585) 266-2163
Mailing address
1299 PORTLAND AVENUE, SUITE 16, ROCHESTER, NY 14621
(585) 266-3300
(585) 266-2163
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
1436371
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01430097
—
NY
01
—
0181311590
EXCELLOS
NY
01
—
102371CU
PREFERRED CARE
NY
Enumeration date
08/24/2006
Last updated
08/22/2020
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