Healthcare Provider Details

I. General information

NPI: 1497784771
Provider Name (Legal Business Name): REBECCA C BUTTERFIELD M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/30/2006
Last Update Date: 08/04/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

391 MYRTLE AVE # 3
ALBANY NY
12208-3835
US

IV. Provider business mailing address

391 MYRTLE AVE # 3
ALBANY NY
12208-3835
US

V. Phone/Fax

Practice location:
  • Phone: 518-262-5588
  • Fax: 518-262-5589
Mailing address:
  • Phone: 518-262-5588
  • Fax: 518-262-5589

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2080C0008X
TaxonomyChild Abuse Pediatrics Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number243831
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: