Active NPI
Raheela Butt
- Anatomic Pathology Physician
- Clifton Park, NY
National Provider Identifier
1740801919
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anatomic Pathology Physician
- License
- 000406-1
- Practice address
- 17 Stablegate Dr
Clifton Park, NY 12065-6796 - Phone
- (518) 428-7742
- NPI assigned
- Apr 29, 2020
- Last updated
- Apr 29, 2020
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anatomic Pathology Physician | 207ZP0101X | 000406-1 | NY | Primary |
Addresses
Primary practice location
17 Stablegate Dr
Clifton Park, NY 12065-6796
Mailing address
17 Stablegate Dr
Clifton Park, NY 12065-6796
Phone (518) 428-7742
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 000406-1 | NY | MD | Anatomic Pathology Physician |
NPI Registry JSON
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": "1740801919",
"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": "518-428-7742"
},
{
"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": "518-428-7742"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BUTT",
"first_name": "RAHEELA",
"sole_proprietor": "YES",
"sex": "F",
"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": "000406-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Clifton Park, NY
Sources for this page
- 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.