Provider Demographics
NPI:1467463232
Name:BUSHEE, MARK L (DC)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:L
Last Name:BUSHEE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
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Mailing Address - Street 1:1399 ROUTE 52 STE 105
Mailing Address - Street 2:
Mailing Address - City:FISHKILL
Mailing Address - State:NY
Mailing Address - Zip Code:12524-3250
Mailing Address - Country:US
Mailing Address - Phone:845-896-3817
Mailing Address - Fax:845-896-3819
Practice Address - Street 1:1399 ROUTE 52
Practice Address - Street 2:STE 105
Practice Address - City:FISHKILL
Practice Address - State:NY
Practice Address - Zip Code:12524-3250
Practice Address - Country:US
Practice Address - Phone:845-896-3817
Practice Address - Fax:845-896-3819
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-10
Last Update Date:2018-11-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NYX008928-1111NN1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN1001XChiropractic ProvidersChiropractorNutrition
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYXOB291Medicare ID - Type Unspecified