DR. DANA G. BUSH (NPI# 1174640668) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174640668 |
| Entity Type | Individual |
| Full Name | DR. DANA G. BUSH |
| Credential | PH.D. |
| Practice Address |
290 Hawkins Ave Ste. B Lake Ronkonkoma NY 11779-9600 |
| Mailing Address |
156 W 56th St Ste 1804 New York NY 10019-3878 |
| Practice Telephone | 6314311581 |
| Mailing Telephone | 2128518100 |
| Mailing Fax Number | 8889772547 |
| Enumeration Date | 2007-03-22 |
| Last Update Date | 2018-05-08 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 103T00000X | Psychologist | 013045 | NY | Behavioral Health & Social Service Providers |
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
013045 | NY | Behavioral Health & Social Service Providers |
| N | 103TC2200X |
Psychologist Specialization: Clinical Child & Adolescent |
013045 | NY | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720321151 | Dana R Bush | Psychologist | 150 Glenwood Ln, Birmingham, AL 35242-5700 | 2013-04-03 |
| 1255589792 | Dana M Bush | Counselor | 671 Hoes Ln W, Piscataway, NJ 08854-8021 | 2008-09-08 |
| 1659575462 | Dana Bush | Audiologist | 311 23rd Ave N, Nashville, TN 37203-1503 | 2007-06-14 |
| 1457457186 | Dana Bush | Obstetrics & Gynecology | 1054 Burrage Rd Ne, Concord, NC 28025-2910 | 2006-09-16 |
| Street Address |
290 HAWKINS AVE STE. B |
| City | LAKE RONKONKOMA |
| State | NY |
| Zip Code | 11779-9600 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003868514 | Shane Bush | Clinical Neuropsychologist | 290 Hawkins Ave, Suite B, Lake Ronkonkoma, NY 11779-9600 | 2006-05-16 |
| 1912024506 | Michael Creta, Do | Family Medicine | 290 Hawkins Ave, Lake Ronkonkoma, NY 11779-9600 | 2007-03-26 |
| 1356467419 | Long Island Neuropsychology, P.C. | Clinical Neuropsychologist | 290 Hawkins Ave, Suite B, Lake Ronkonkoma, NY 11779-9600 | 2007-03-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750929139 | Sebastian Godinez | Student in an Organized Health Care Education/Training Program | 11 First Street, Ronkonkoma, NY 11779 | 2019-12-16 |
| 1487149860 | John Deming | Student in an Organized Health Care Education/Training Program | 142 - 02 20th Avenue, Flushing, NY 11779 | 2018-06-27 |
| 1376060392 | Janine D'annunzio | Specialist | 316 Thirft Street, Ronkonkoma, NY 11779 | 2017-08-30 |
| 1932621935 | Vincent Joseph Lopreto | Counselor | 253 Lake Shore Road, Ronkonkoma, NY 11779 | 2017-07-11 |
| 1598295271 | Dalas Taddeo | Licensed Practical Nurse | 4490 Express Drive S, Ronkonkoma, NY 11779 | 2017-06-15 |
| 1790214112 | Pamela Ferrante | Social Worker | 131 Avenue D, Ronkonkoma, NY 11779 | 2017-06-08 |
| 1255868915 | Bari Home Care LLC | Health Maintenance Organization | 4417 Express Drive North, Ronkonkoma, NY 11779 | 2017-05-12 |
| 1013441328 | Caring Hands Home Care | Nursing Facility/Intermediate Care Facility | 65 Cheryl Drive, Ronkonkoma, NY 11779 | 2017-04-13 |
| 1831552025 | Jacqueline Galdamez | Social Worker | 979 Johnson Avenue, Ronkonkoma, NY 11779 | 2016-04-04 |
| 1891192530 | Alex Mitchell Pollack | Massage Therapist | 34 Richmond Blvd, #3a, Ronkonkoma, NY 11779 | 2014-11-24 |
| Find all providers in zip 11779 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396346060 | Alexandra Hittman | Psychologist | 26 Palisade St, Dobbs Ferry, NY 10522-2107 | 2020-11-07 |
| 1184225849 | Linda L Street | Psychologist | 165 Saint Regis Dr, Massapequa Park, NY 11762-3454 | 2020-11-07 |
| 1063012318 | Inga Korsgaard | Psychologist | 233 Broadway Rm 850, New York, NY 10279-0800 | 2020-10-27 |
| 1194324657 | Elizabeth Brunoski | Psychologist | 50 W 67th St Ste 5h, New York, NY 10023-6227 | 2020-10-25 |
| 1760081830 | Meagan Ryan | Psychologist | 1 3rd Ave Apt 516, Mineola, NY 11501-4340 | 2020-10-20 |
| 1912505587 | Elspeth Hayden Kelly | Psychologist | 519 8th Ave Fl 8, New York, NY 10018-6506 | 2020-10-15 |
| 1700484623 | Rena Lee Miller | Psychologist | 252 N 6th St Apt 17, Brooklyn, NY 11211-3367 | 2020-10-13 |
| 1558968842 | Ethan Eisen | Psychologist | 107 Lakeside Dr E, Lawrence, NY 11559-1718 | 2020-10-08 |
| 1790382398 | Katelynn Marie Faulkner | Psychologist | 1 Old Plank Rd # 1d, Clinton, NY 13323-1802 | 2020-10-06 |
| 1811594039 | Pinchus Feintuch | Psychologist | 1580 E 18th St Ste 101, Brooklyn, NY 11230-7261 | 2020-10-01 |
| Find all providers with the same taxonomy | ||||
| City | LAKE RONKONKOMA |
| Zip Code | 11779 |
Please comment or provide details below to improve the information on DR. DANA G. BUSH.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.