MEDICARE: MS. JUDIE MARIE BUTLER RPH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	045495	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1306029194
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. JUDIE MARIE BUTLER RPH

Provider Business Mailing Address
First Line	:	750 MANHATTAN AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11222-2910
Country	:	US
Telephone Number	:	718-383-7967
Fax Number	:

Provider Business Practice Location Address
First Line	:	750 MANHATTAN AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11222-2910
Country	:	US
Telephone Number	:	718-383-7967
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/14/2007
Last Update Date	:	02/17/2023

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