Provider Demographics
NPI:1386757144
Name:BUTLER, BARBARA (OD)
Entity type:Individual
Prefix:DR
First Name:BARBARA
Middle Name:
Last Name:BUTLER
Suffix:
Gender:F
Credentials:OD
Other - Prefix:DR
Other - First Name:BARBARA
Other - Middle Name:
Other - Last Name:SCHNEIDER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:PO BOX 834
Mailing Address - Street 2:17 SOUTH ST
Mailing Address - City:DRYDEN
Mailing Address - State:NY
Mailing Address - Zip Code:13053-0834
Mailing Address - Country:US
Mailing Address - Phone:607-351-4467
Mailing Address - Fax:
Practice Address - Street 1:135 FAIRGROUNDS PARKWAY
Practice Address - Street 2:WAL-MART VISION CENTER
Practice Address - City:ITHACA
Practice Address - State:NY
Practice Address - Zip Code:14850
Practice Address - Country:US
Practice Address - Phone:607-277-8984
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006754152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist