Healthcare Provider Details

I. General information

NPI: 1184800344
Provider Name (Legal Business Name): DANIELLE ARI BUTLER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DANIELLE BUTLER MD

II. Dates (important events)

Enumeration Date: 01/17/2008
Last Update Date: 12/05/2022
Certification Date: 12/05/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 HADDONFIELD RD
CHERRY HILL NJ
08002-2604
US

IV. Provider business mailing address

22 ADAMS LN
HAINESPORT NJ
08036-2600
US

V. Phone/Fax

Practice location:
  • Phone: 856-663-7690
  • Fax: 856-763-9269
Mailing address:
  • Phone: 973-698-9379
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number046822
License Number StateCT
# 3
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD475399
License Number StatePA
# 4
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number25MA10199300
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: