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NPI Code Detail

MEDICARE: HAILEY NICOLE NILES PA-C

MEDICARE: HAILEY NICOLE NILES PA-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician AssistantNY

General Provider Information

NPI Number : 1164377289
Entity Type Code : Individual
Provider Name (Legal Business Name) : HAILEY NICOLE NILES PA-C
Provider Business Mailing Address
First Line : 601 ELMWOOD AVE
Second Line :
City : ROCHESTER
State : NY
Zip : 14642-0002
Country : US
Telephone Number : 585-275-2100
Fax Number :
Provider Business Practice Location Address
First Line : 601 ELMWOOD AVE
Second Line :
City : ROCHESTER
State : NY
Zip : 14642-0002
Country : US
Telephone Number : 585-275-2100
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/03/2026
Last Update Date : 03/03/2026

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1770569584 — ELIZABETH A POWLEY NP
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1326014770 — KEVIN A WALTER MD
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Directions to “ HAILEY NICOLE NILES PA-C” Practice Location

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