Provider Demographics
NPI:1780815167
Name:BUTTS, GARY C (MD)
Entity Type:Individual
Prefix:DR
First Name:GARY
Middle Name:C
Last Name:BUTTS
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Gender:M
Credentials:MD
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Mailing Address - Street 1:1 GUSTAVE L LEVY PL
Mailing Address - Street 2:MOUNT SINAI HOSPITAL
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10029-6500
Mailing Address - Country:US
Mailing Address - Phone:212-241-8276
Mailing Address - Fax:212-241-3594
Practice Address - Street 1:1 GUSTAVE L LEVY PL
Practice Address - Street 2:MOUNT SINAI HOSPITAL
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10029-6500
Practice Address - Country:US
Practice Address - Phone:212-241-8276
Practice Address - Fax:212-241-3594
Is Sole Proprietor?:No
Enumeration Date:2009-08-03
Last Update Date:2009-08-03
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Provider Licenses
StateLicense IDTaxonomies
NY152907208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYB03424Medicare UPIN