Individual
SHANE BUSH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
290 HAWKINS AVE, SUITE B, LAKE RONKONKOMA, NY 11779-9600
(631) 334-7884
(631) 980-3715
Mailing address
290 HAWKINS AVE, SUITE B, LAKE RONKONKOMA, NY 11779-9600
(631) 334-7884
(631) 980-3715
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
012998
NY
103TC0700X
Clinical Psychologist
012998-2
NY
103TR0400X
Rehabilitation Psychologist
012998
NY
Other
Enumeration date
05/16/2006
Last updated
07/18/2007
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us