Shane Bush
Clinical Psychologist Rehabilitation Psychologist
290 Hawkins Ave Suite B
Lake Ronkonkoma
, New York 11779-9600
Shane Bush
Clinical Psychologist Rehabilitation Psychologist
290 Hawkins Ave Suite B
Lake Ronkonkoma
, New York 11779-9600
(631) 980-3715
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About
Features
Specialties
- Clinical Psychologist
- Rehabilitation Psychologist
Languages spoken
- English
Location
First Address
- Shane Bush
- 290 Hawkins Ave Suite B
- Lake Ronkonkoma, NY
- Zip : 11779-9600
- Fax : (631) 980-3715
- Phone : (631) 334-7884
Second Address
- Shane Bush
- 290 Hawkins Ave Suite B
- Lake Ronkonkoma, NY
- Zip : 11779-9600
- Fax : (631) 980-3715
- Phone : (631) 334-7884
Reviews
FAQs
Where did Shane Bush attend graduate school?
Where did Shane Bush do his residency?
Where did Shane Bush do his fellowship?
Is Shane Bush board certified?
What type of doctor is Shane Bush
In what state does Shane Bush practice in?
Where is Shane Bush ’s practice located?
What is Shane Bush ’s gender?
Is Shane Bush a sole practitioner?
Is Shane Bush accepting new patients?
What languages does Shane Bush speak?
Does Shane Bush accept insurance?
Does Shane Bush offers telemedicine?
What is Shane Bush ’s professional license number?
What is Shane Bush ’s NPI number?
Does Shane Bush have any license restrictions?
Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 103G00000X | Clinical Psychologist | 012998 | NY |
| Y | 103TC0700X | Clinical Psychologist | 012998 | NY |
| N | 103G00000X | Clinical Psychologist | 012998-2 | NY |
| N | 103TC0700X | Clinical Psychologist | 012998-2 | NY |
| N | 103TR0400X | Rehabilitation Psychologist | 012998 | NY |
National Provider Identifier
| NPI | 1003868514 |
|---|---|
| Provider Name | Shane Bush |
| First Address | Lake Ronkonkoma, NY 11779-9600 |
| Second Address | Lake Ronkonkoma, NY 11779-9600 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 16/05/2006 |
| Last Update Date | 18/07/2007 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.