Provider Demographics
NPI:1720385487
Name:BUTLER, CHERYL SUE
Entity Type:Individual
Prefix:
First Name:CHERYL
Middle Name:SUE
Last Name:BUTLER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 RECTOR PL
Mailing Address - Street 2:#27F
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10280-1107
Mailing Address - Country:US
Mailing Address - Phone:212-924-9040
Mailing Address - Fax:
Practice Address - Street 1:200 RECTOR PL
Practice Address - Street 2:#27F
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10280-1107
Practice Address - Country:US
Practice Address - Phone:212-924-9040
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-02-16
Last Update Date:2011-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005133225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics