Individual
KIRSTEN L GRUIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
90 PRESIDENTIAL PLZ, 4TH FLOOR - NEUROLOGY, SYRACUSE, NY 13202-2240
(315) 464-4243
(315) 464-5350
Mailing address
90 PRESIDENTIAL PLZ, 4TH FLOOR - NEUROLOGY, SYRACUSE, NY 13202-2240
(315) 464-4243
(315) 464-5350
Taxonomy
Speciality
Code
Description
License number
State
2084N0008X
Neuromuscular Medicine (Psychiatry & Neurology) Physician
Primary
263856
NY
2084N0400X
Neurology Physician
263856
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03423003
—
NY
Enumeration date
10/11/2006
Last updated
12/13/2012
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