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NPI Code Detail

MEDICARE: MR. ANDREW SCOTT BUSHING CASAC

MEDICARE: MR. ANDREW SCOTT BUSHING CASAC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YA0400XAddiction (Substance Use Disorder) Counselor21444NY

General Provider Information

NPI Number : 1568603694
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. ANDREW SCOTT BUSHING CASAC
Provider Business Mailing Address
First Line : 134 W 15TH ST
Second Line : #2RW
City : NEW YORK
State : NY
Zip : 10011-6721
Country : US
Telephone Number : 646-391-8330
Fax Number :
Provider Business Practice Location Address
First Line : 16 WESTCHESTER SQ
Second Line :
City : BRONX
State : NY
Zip : 10461-3513
Country : US
Telephone Number : 718-518-9007
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/19/2009
Last Update Date : 03/19/2009

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