NPI 1639918980 · live from the CMS NPI Registry
Sydney Ann Butalla, OD
Optometrist in Portland, ME. National Provider Identifier 1639918980, active.
NPI record
| NPI | 1639918980 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Optometrist 152W00000X |
| Practice location | 152 Middle St, Portland, ME 04101 |
| Practice phone | 207-775-1819 |
| Mailing address | 8 Rogers Rd Unit 207, Freeport, ME 04032 |
| Enumerated | May 24, 2024 |
| Last updated | June 11, 2025 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Optometrist primary | 152W00000X | OPT1088 (ME) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.