Provider Demographics
NPI:1770562530
Name:BUTTARI, VALNEO M (MD)
Entity type:Individual
Prefix:
First Name:VALNEO
Middle Name:M
Last Name:BUTTARI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2149
Mailing Address - Street 2:
Mailing Address - City:DANBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06813-2149
Mailing Address - Country:US
Mailing Address - Phone:914-668-5944
Mailing Address - Fax:
Practice Address - Street 1:127 E LINCOLN AVE
Practice Address - Street 2:
Practice Address - City:MT VERNON
Practice Address - State:NY
Practice Address - Zip Code:10552-3208
Practice Address - Country:US
Practice Address - Phone:914-668-5944
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-11
Last Update Date:2023-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY223321207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02423783Medicaid
NY062AP1Medicare ID - Type Unspecified
NY02423783Medicaid