Shane Bush is a Rehabilitation in Lake Ronkonkoma, New York. Shane Bush practices all healthcare services and medical treatments related to Rehabilitation. The NPI Number for Shane Bush is 1003868514. The last update date is 2007-07-18.
Shane Bush's current location address is 290 Hawkins Ave, Lake Ronkonkoma, New York. You can contact this provider via phone number 6313347884 and fax number 6319803715. The mailing address for Shane Bush is 290 Hawkins Ave, Lake Ronkonkoma, New York. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Shane Bush |
|---|---|
| Address | 290 Hawkins Ave, Lake Ronkonkoma, New York |
| Phone Number | 6313347884 |
| Fax Number | 6319803715 |
| Sole Proprietor | Y |
| Credentials | PH.D. |
NPI Number Detail
| NPI Number | 1003868514 |
|---|---|
| Provider Enumeration Date | 2006-05-16 |
| Last Updated Date | 2007-07-18 |
Provider Mailing Address Detail
| Address | 290 Hawkins Ave |
|---|---|
| City | Lake Ronkonkoma |
| State | New York (NY) |
| Post Code | 117799600 |
| Phone Number | 6313347884 |
| Fax Number | 6319803715 |
Provider's Primary Taxonomy Detail
| Speciality | Rehabilitation |
|---|---|
| Taxonomy | 103Tr0400X |
| Licence No | 12998 |
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Definition: A psychologist who specializes in the study and application of psychological principles on behalf of persons who have disability due to injury or illness. Rehabilitation psychologists, often within teams, assess and treat cognitive, emotional, and fu |
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Post Comment/ Review Below
What is the unique identifier code issued to Shane Bush by the Centers for Medicare & Medicaid Services (CMS)?
The Shane Bush has been assigned the NPI (National Provider Identifier) 1003868514. This 10-digit code serves as a unique identification number for healthcare providers, issued by the CMS.
Could you please share the complete physical address where Shane Bush is geographically located?
The Shane Bush is physically situated at the following location: 290 Hawkins Ave, Lake Ronkonkoma, NY, 117799600.
What is Shane Bush's specialized field of practice, and what is the corresponding taxonomy classification code?
The Shane Bush's area of specialization is Rehabilitation, and the corresponding taxonomy code that categorizes this field of practice is 103Tr0400X.
When was the Shane Bush's 1003868514 issued?
The Shane Bush's 1003868514 was issued on 2006-05-16.
When was the information related to Shane Bush most recently updated or refreshed?
The details pertaining to the Shane Bush, including its address, specialty, and other relevant information, were last updated or refreshed on 2007-07-18.