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General NPI Number Information
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NPI Number | 1780626531
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Entity Type | Individual
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Provider Name | RICHARD A BUTZ RPA-C
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Gender | Male
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Dates
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Enumeration Date | 06/12/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1322 GERLING ST
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City | SCHENECTADY
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State | NY
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Zip | 12308-1702
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Country | US
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Telephone | 518-345-3334
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Fax | 518-346-4030
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Provider Business Mailing Address
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Address Line | PO BOX 151
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City | BLUE MOUNTAIN LAKE
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State | NY
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Zip | 12812-0151
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Country | US
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Telephone | 518-352-7737
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Fax | 518-346-4030
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 006779-1
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License Number State | NY
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