Individual
DR. DANA G. BUSH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
290 HAWKINS AVE, STE. B, LAKE RONKONKOMA, NY 11779-9600
(631) 431-1581
Mailing address
156 W 56TH ST STE 1804, NEW YORK, NY 10019-3878
(212) 851-8100
(888) 977-2547
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
013045
NY
103TC0700X
Clinical Psychologist
Primary
013045
NY
103TC2200X
Clinical Child & Adolescent Psychologist
013045
NY
Other
Enumeration date
03/22/2007
Last updated
05/08/2018
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