Provider Demographics
NPI:1750973327
Name:BUTERA, ERIN L
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:L
Last Name:BUTERA
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 1:2790 POST RD
Mailing Address - Street 2:
Mailing Address - City:WARWICK
Mailing Address - State:RI
Mailing Address - Zip Code:02886-3113
Mailing Address - Country:US
Mailing Address - Phone:401-739-3173
Mailing Address - Fax:401-738-9945
Practice Address - Street 1:2790 POST RD
Practice Address - Street 2:
Practice Address - City:WARWICK
Practice Address - State:RI
Practice Address - Zip Code:02886-3113
Practice Address - Country:US
Practice Address - Phone:401-739-3173
Practice Address - Fax:401-738-9945
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-05
Last Update Date:2021-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI04035183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist