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Forrest Tyler Butensky, DO
Student in an Organized Health Care Education/Training Program in Riverhead, New York
NPI 1043913510

Forrest Tyler Butensky is a Student in an Organized Health Care Education/Training Program based in Riverhead, NY. Forrest Tyler Butensky practices in Riverhead, NY and has the professional credentials of DO. The NPI Number for Forrest Tyler Butensky is 1043913510 and holds a License No. (New York).

The current practice location address for Forrest Tyler Butensky is 1300 Roanoke Ave, Riverhead, NY and can be reached out via phone at 631-548-6000.

Location: 1300 Roanoke Ave, Riverhead, NY, 11901-2031
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1043913510
Provider Name
Forrest Tyler Butensky
Credential
DO
Provider Entity Type
Individual
Gender
Male
Address
1300 Roanoke Ave, Riverhead, NY, 11901-2031
Phone Number
631-548-6000
Fax Number
Provider Enumeration Date
03/23/2023
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
1300 Roanoke Ave
City
Riverhead
State
New York
Zip
11901-2031
Phone Number
631-548-6000
Fax Number
person
Provider Business Mailing Address Details
Address
1300 Roanoke Ave
City
Riverhead
State
New York
Zip
11901-2031
Phone Number
631-548-6000
Fax Number
person
Provider's Taxonomy Details 1
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
()
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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