Provider Demographics
NPI:1831426758
Name:GEORGE BUSH MD
Entity type:Organization
Organization Name:GEORGE BUSH MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHIATRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ALLAN
Authorized Official - Middle Name:GEORGE
Authorized Official - Last Name:BUSH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:516-673-8060
Mailing Address - Street 1:111 7TH ST
Mailing Address - Street 2:SUITE 111
Mailing Address - City:GARDEN CITY
Mailing Address - State:NY
Mailing Address - Zip Code:11530-5731
Mailing Address - Country:US
Mailing Address - Phone:516-673-8060
Mailing Address - Fax:617-606-3910
Practice Address - Street 1:111 7TH ST
Practice Address - Street 2:SUITE 111
Practice Address - City:GARDEN CITY
Practice Address - State:NY
Practice Address - Zip Code:11530-5731
Practice Address - Country:US
Practice Address - Phone:516-673-8060
Practice Address - Fax:617-606-3910
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-13
Last Update Date:2009-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1886682084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty