MEDICARE: BRIAN BUTLER DPM PC

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	174400000X	Specialist	N003220	NY

General Provider Information

NPI Number	:	1952371270
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BRIAN BUTLER DPM PC

Provider Business Mailing Address
First Line	:	77 SAGAMORE RD
Second Line	:
City	:	BRONXVILLE
State	:	NY
Zip	:	10708-1506
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1 HANSON PL
Second Line	:	SUITE 1215
City	:	BROOKLYN
State	:	NY
Zip	:	11243-2907
Country	:	US
Telephone Number	:	718-230-4844
Fax Number	:

Authorized Official
Title or Position	:	SOLE PROPRIETER
Name	:	BRIAN BUTLER
Credential	:
Telephone Number	:	718-230-4844

Provider Enumeration Date	:	01/26/2006
Last Update Date	:	08/22/2020

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