Individual
MRS. COLLEEN ELI BUTT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
216 BROADWAY, CARLE PLACE, NY 11514-1611
(516) 242-0772
Mailing address
216 BROADWAY, CARLE PLACE, NY 11514-1611
(516) 242-0772
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
NY
Other
Enumeration date
06/07/2012
Last updated
06/07/2012
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