Shane Bush, PH.D.
NPI #1003868514 in Lake Ronkonkoma, New York
Provider Information
- NPI Number
- 1003868514
- Entity Type
- Individual
- Name
- Shane Bush, PH.D.
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Clinical Neuropsychologist
- Credential
- PH.D.
- Enumeration Date
- May 16, 2006
- Last Updated
- Jul 18, 2007
Practice Location
- Address
- 290 HAWKINS AVE
- Address 2
- SUITE B
- City
- Lake Ronkonkoma
- State
- New York
- ZIP Code
- 11779-9600
- Phone
- (631) 334-7884
Specialties & Taxonomy Codes
| Specialty |
|---|
| Psychologist - Clinical — Clinical |
| Clinical Neuropsychologist |
| Psychologist - Rehabilitation — Rehabilitation |
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