Provider Demographics
NPI:1467638452
Name:BUTLER, JULIE MARIE (DOCTOR OF PHARMACY)
Entity Type:Individual
Prefix:DR
First Name:JULIE
Middle Name:MARIE
Last Name:BUTLER
Suffix:
Gender:F
Credentials:DOCTOR OF PHARMACY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:RICHFIELD SPRINGS
Mailing Address - State:NY
Mailing Address - Zip Code:13439-2535
Mailing Address - Country:US
Mailing Address - Phone:315-858-3229
Mailing Address - Fax:315-858-6689
Practice Address - Street 1:10 MAIN ST
Practice Address - Street 2:
Practice Address - City:RICHFIELD SPRINGS
Practice Address - State:NY
Practice Address - Zip Code:13439-2535
Practice Address - Country:US
Practice Address - Phone:315-858-3229
Practice Address - Fax:315-858-6689
Is Sole Proprietor?:No
Enumeration Date:2008-01-21
Last Update Date:2021-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY051316-1183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00911431Medicaid