Healthcare Provider Details

I. General information

NPI: 1467463232
Provider Name (Legal Business Name): MARK L. BUSHEE DC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/10/2006
Last Update Date: 10/21/2024
Certification Date: 10/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1401 ROUTE 52 STE 100
FISHKILL NY
12524-3255
US

IV. Provider business mailing address

1401 ROUTE 52 STE 100
FISHKILL NY
12524-3255
US

V. Phone/Fax

Practice location:
  • Phone: 845-896-3817
  • Fax: 845-896-3819
Mailing address:
  • Phone: 845-896-3817
  • Fax: 845-896-3819

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111NN1001X
TaxonomyNutrition Chiropractor
License NumberX008928-1
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberX008928-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: