MEDICARE: JACK DUSHEY MD

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
1	207R00000X	Internal Medicine Physician	109659	NY
2	207RG0100X	Gastroenterology Physician	109659	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	221689SJ	OTHER	NY	WORKERS COMP
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1851354773
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JACK DUSHEY MD

Provider Business Mailing Address
First Line	:	14 SOUNDVIEW AVE
Second Line	:	APT 1
City	:	WHITE PLAINS
State	:	NY
Zip	:	10606-3327
Country	:	US
Telephone Number	:	914-949-5770
Fax Number	:	914-949-5573

Provider Business Practice Location Address
First Line	:	14 SOUNDVIEW AVE
Second Line	:	APT 1
City	:	WHITE PLAINS
State	:	NY
Zip	:	10606-3327
Country	:	US
Telephone Number	:	914-949-5770
Fax Number	:	914-949-5573

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/11/2006
Last Update Date	:	09/11/2025

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