Individual
JENNA BUTNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
20 YORK ST, NEW HAVEN, CT 06510
(203) 688-4242
Mailing address
407 PARK AVE S APT 24E, NEW YORK, NY 10016-8420
(516) 721-6717
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
053322
CT
207Q00000X
Family Medicine Physician
270676
NY
207QA0505X
Adult Medicine Physician
MD17941
RI
207R00000X
Internal Medicine Physician
53322
CT
207RA0401X
Addiction Medicine (Internal Medicine) Physician
053322
CT
2083A0300X
Addiction Medicine (Preventive Medicine) Physician
Primary
270676
NY
208M00000X
Hospitalist Physician
270676
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
004217099
PCS MEDICAID NH
CT
01
—
008039745
PCS MEDICAID (BPT)
CT
01
—
008053091
DR. BUTNER MEDICAID #
CT
01
—
D400172220
BUTNER MEDICARE
CT
Enumeration date
06/30/2010
Last updated
05/13/2024
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