Provider Demographics
NPI:1922716661
Name:BUSHEY, GIANNA NICOLE
Entity Type:Individual
Prefix:
First Name:GIANNA
Middle Name:NICOLE
Last Name:BUSHEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:140 ALYSSA CIR
Mailing Address - Street 2:
Mailing Address - City:UTICA
Mailing Address - State:NY
Mailing Address - Zip Code:13502-8203
Mailing Address - Country:US
Mailing Address - Phone:315-292-8171
Mailing Address - Fax:
Practice Address - Street 1:37 BURTON ST
Practice Address - Street 2:
Practice Address - City:CAZENOVIA
Practice Address - State:NY
Practice Address - Zip Code:13035-1148
Practice Address - Country:US
Practice Address - Phone:315-655-1325
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-11
Last Update Date:2022-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY027409225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist