Provider Demographics
NPI:1649435975
Name:BUTKA, PATRICIA CATHERINE (REGISTERED NURSE)
Entity type:Individual
Prefix:MS
First Name:PATRICIA
Middle Name:CATHERINE
Last Name:BUTKA
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9016 51ST AVE
Mailing Address - Street 2:
Mailing Address - City:ELMHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11373-4012
Mailing Address - Country:US
Mailing Address - Phone:718-271-5581
Mailing Address - Fax:718-393-3979
Practice Address - Street 1:9016 51ST AVE
Practice Address - Street 2:
Practice Address - City:ELMHURST
Practice Address - State:NY
Practice Address - Zip Code:11373-4012
Practice Address - Country:US
Practice Address - Phone:718-271-5581
Practice Address - Fax:718-393-3979
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-25
Last Update Date:2008-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY302998163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse