Iftikhar Butt, PA

Primary specialty

Anatomic Pathology PhysicianTaxonomy code 207ZP0101X

License

0350191 Issued in NY

Practice address

17 Stablegate Dr
Clifton Park, NY 12065-6796

Phone

(518) 210-5571

NPI assigned

Apr 29, 2020

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Physician Assistant

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1588118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588118400000",
    "number": "1376164541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 STABLEGATE DR",
            "city": "CLIFTON PARK",
            "state": "NY",
            "postal_code": "120656796",
            "telephone_number": "518-210-5571"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17 STABLEGATE DR",
            "city": "CLIFTON PARK",
            "state": "NY",
            "postal_code": "120656796",
            "telephone_number": "518-210-5571"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUTT",
        "first_name": "IFTIKHAR",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-04-29",
        "last_updated": "2020-04-29",
        "certification_date": "2020-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0101X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology",
            "state": "NY",
            "license": "0350191",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Miro G Burjetka, DDS
• Tara A Burke-Muscatello, FNP-BC
• Dianne Elizabeth Burke, L.C.S.W.
• Jared Michael Burridge, PHARM. D.
• Rachelle Butler
• Raheela Butt
• Robert Allan Butz Jr., PH.D.
• Randy L Cale, PH.D.
• Caleb a. George & Alan F. Justin
• Lawrence Jesse Dela Pena Camacho, DDS

• Anatomic Pathology Physician in Clifton Park, NY
• Providers in Clifton Park, NY by specialty
• Anatomic Pathology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.