Provider Demographics
NPI:1053994657
Name:KRUTSICK, ABIGAIL MARIE (DPM)
Entity type:Individual
Prefix:DR
First Name:ABIGAIL
Middle Name:MARIE
Last Name:KRUTSICK
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 S 16TH ST STE 1700
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19102-2516
Mailing Address - Country:US
Mailing Address - Phone:484-535-3285
Mailing Address - Fax:
Practice Address - Street 1:50 BERKSHIRE CT STE 1
Practice Address - Street 2:
Practice Address - City:WYOMISSING
Practice Address - State:PA
Practice Address - Zip Code:19610-1219
Practice Address - Country:US
Practice Address - Phone:610-373-4154
Practice Address - Fax:610-373-8651
Is Sole Proprietor?:No
Enumeration Date:2021-04-30
Last Update Date:2024-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASC007205213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist