Provider Demographics
NPI:1497784771
Name:BUTTERFIELD, REBECCA C (MD)
Entity Type:Individual
Prefix:DR
First Name:REBECCA
Middle Name:C
Last Name:BUTTERFIELD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:391 MYRTLE AVE # 3
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12208-3835
Mailing Address - Country:US
Mailing Address - Phone:518-262-5588
Mailing Address - Fax:518-262-5589
Practice Address - Street 1:391 MYRTLE AVE # 3
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12208-3835
Practice Address - Country:US
Practice Address - Phone:518-262-5588
Practice Address - Fax:518-262-5589
Is Sole Proprietor?:No
Enumeration Date:2006-06-30
Last Update Date:2019-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
2080C0008X
NY243831208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No2080C0008XAllopathic & Osteopathic PhysiciansPediatricsChild Abuse Pediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30206082Medicaid
NH1115988004OtherCIGNA
NH31522YOtherANTHEM PROVIDER #
NH1290823OtherAETNA PROVIDER #
ME432307699Medicaid
NHAA63228OtherHARVARD PILGRIM PROVIDER