Provider Demographics
NPI:1750919494
Name:KRUITHOFF, MARGARET LOUISE (MD)
Entity type:Individual
Prefix:
First Name:MARGARET
Middle Name:LOUISE
Last Name:KRUITHOFF
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:990 SOUTH AVE
Mailing Address - Street 2:SUITE 207
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14620-2762
Mailing Address - Country:US
Mailing Address - Phone:585-341-6775
Mailing Address - Fax:585-341-8310
Practice Address - Street 1:990 SOUTH AVE
Practice Address - Street 2:SUITE 207
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14620-2762
Practice Address - Country:US
Practice Address - Phone:585-341-6775
Practice Address - Fax:585-341-8310
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-30
Last Update Date:2024-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
NY325697207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program