Provider Demographics
NPI:1073019378
Name:PUELLE, MARGARET R (MD)
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:R
Last Name:PUELLE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:300 CRITTENDEN BLVD BOX PSYCH EDUCATION
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14642-3377
Mailing Address - Country:US
Mailing Address - Phone:585-274-1278
Mailing Address - Fax:267-282-3814
Practice Address - Street 1:300 CRITTENDEN BLVD BOX PSYCH EDUCATION
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14642-3377
Practice Address - Country:US
Practice Address - Phone:585-274-1278
Practice Address - Fax:267-282-3814
Is Sole Proprietor?:No
Enumeration Date:2018-04-04
Last Update Date:2023-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY3176602084P0800X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry