Provider Demographics
NPI:1467633917
Name:BUTLER, SHEILA (RPH)
Entity Type:Individual
Prefix:MISS
First Name:SHEILA
Middle Name:
Last Name:BUTLER
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18131 DALNY RD
Mailing Address - Street 2:
Mailing Address - City:JAMAICA
Mailing Address - State:NY
Mailing Address - Zip Code:11432-2340
Mailing Address - Country:US
Mailing Address - Phone:718-526-3432
Mailing Address - Fax:
Practice Address - Street 1:2119 MERRICK RD
Practice Address - Street 2:
Practice Address - City:MERRICK
Practice Address - State:NY
Practice Address - Zip Code:11566-4704
Practice Address - Country:US
Practice Address - Phone:516-867-0956
Practice Address - Fax:516-867-0785
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-26
Last Update Date:2007-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY038763183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist