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General NPI Number Information
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NPI Number | 1902975089
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Entity Type | Organization
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Legal Business Name | ATUL BUTALA PHYSICIAN PC
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Dates
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Enumeration Date | 11/06/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 807 NEWELL STREET
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City | UTICA
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State | NY
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Zip | 13502
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Country | US
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Telephone | 315-798-9300
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Fax | 315-793-8320
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Provider Business Mailing Address
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Address Line | 807 NEWELL STREET
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City | UTICA
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State | NY
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Zip | 13502
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Country | US
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Telephone | 315-798-9300
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Fax | 315-793-8320
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ATUL V BUTALA
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Credential | MD FACP
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Telephone | 315-798-9300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number |
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License Number State |
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