Individual
DR. BRUCE STEPHEN PORTNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1160 CHILI AVENUE, ROCHESTER, NY 14624
(516) 729-2326
(516) 922-0602
Mailing address
6 MARYANNE CT, HUNTINGTON, NY 11743-2949
(516) 729-2326
(516) 922-0602
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
179825
NY
207R00000X
Internal Medicine Physician
Primary
9501640
NC
208000000X
Pediatrics Physician
9501640
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
68502
—
NC
01
—
P00717620
RR MEDICARE
NC
Enumeration date
08/01/2006
Last updated
03/31/2026
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