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General NPI Number Information
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NPI Number | 1053660928
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Entity Type | Organization
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Legal Business Name | RAHILA BUTT MD PC
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Dates
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Enumeration Date | 09/06/2012
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Last Update Date | 09/06/2012
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Provider Practice Location Address
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Address Line | 295 RALPH AVE
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City | BROOKLYN
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State | NY
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Zip | 11233-2206
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Country | US
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Telephone | 718-604-0717
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Fax | 718-604-0718
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Provider Business Mailing Address
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Address Line | 25 JOE DIMAGGIO DR
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City | TRENTON
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State | NJ
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Zip | 08620-2621
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Country | US
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Telephone | 609-585-0963
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Fax |
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Authorized Official
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Title or Position | MD
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Name | RAHILA BUTT
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Credential |
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Telephone | 718-857-0712
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 231434
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License Number State | NY
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