Portland Pediatric Group, LLP

NPI #1174745285 in Rochester, New York

Provider Information

NPI Number: 1174745285
Entity Type: Organization
Organization Name: Portland Pediatric Group, LLP
Primary Specialty: Pediatrics
Enumeration Date: May 2, 2007
Last Updated: Aug 31, 2012

Practice Location

Address: 1700 HUDSON AVE
City: Rochester
State: New York
ZIP Code: 14617-5104
Phone: (585) 342-5694

Authorized Official

Name: DR. RODERICK G DAVIS, M.D
Title: PRESIDENT
Phone: (585) 342-5694

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Pediatrics	208000000X	Primary

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