Individual
CODY JAMES BUTLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
315 S MANNING BLVD, ALBANY, NY 12208-1707
(518) 525-1550
(518) 525-6545
Mailing address
PO BOX 14890, ALBANY, NY 12212-4890
(518) 525-5636
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
028387
NY
Other
Enumeration date
04/05/2022
Last updated
06/29/2022
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