Provider Demographics
NPI:1740570944
Name:BUTRYMOWICZ, ANNA
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:
Last Name:BUTRYMOWICZ
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 1:2380 SUTTER ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94115-3006
Mailing Address - Country:US
Mailing Address - Phone:415-353-2757
Mailing Address - Fax:415-353-2603
Practice Address - Street 1:2380 SUTTER ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94115-3006
Practice Address - Country:US
Practice Address - Phone:415-353-2757
Practice Address - Fax:415-353-2603
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-10
Last Update Date:2021-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA155938207Y00000X
NY2281153207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology