Provider Demographics
NPI:1891749743
Name:BUTERA, JUDITH CANO (AUD)
Entity Type:Individual
Prefix:DR
First Name:JUDITH
Middle Name:CANO
Last Name:BUTERA
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 W TRENTON AVE
Mailing Address - Street 2:PO BOX 46
Mailing Address - City:YARDLEY
Mailing Address - State:PA
Mailing Address - Zip Code:19067-3571
Mailing Address - Country:US
Mailing Address - Phone:215-295-7126
Mailing Address - Fax:215-295-1403
Practice Address - Street 1:900 W TRENTON AVE
Practice Address - Street 2:
Practice Address - City:YARDLEY
Practice Address - State:PA
Practice Address - Zip Code:19067-3571
Practice Address - Country:US
Practice Address - Phone:215-295-7126
Practice Address - Fax:215-295-1403
Is Sole Proprietor?:No
Enumeration Date:2006-05-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAAT000517-L231H00000X
NJYA00268231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA23173OtherAETNA/USHC
PA0426722000OtherKEYSTONE HEALTH PLAN EAST
PAP00031265OtherMEDICARE RAILROAD
PA214105OtherHIGHMARK BCBS
PAP00031265OtherMEDICARE RAILROAD