Provider Demographics
NPI:1841385846
Name:GRINDROD, MARGUERITE JO (CNM)
Entity Type:Individual
Prefix:MS
First Name:MARGUERITE
Middle Name:JO
Last Name:GRINDROD
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7616 ROUTE 31
Mailing Address - Street 2:
Mailing Address - City:LYONS
Mailing Address - State:NY
Mailing Address - Zip Code:14489-9116
Mailing Address - Country:US
Mailing Address - Phone:585-953-8419
Mailing Address - Fax:
Practice Address - Street 1:2425 CLOVER ST
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14618-4517
Practice Address - Country:US
Practice Address - Phone:585-953-8419
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-04
Last Update Date:2020-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF000269176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01066384Medicaid