National Provider Identifier
Madeline Grace Bush
Madeline Grace Bush is listed in the NPPES registry with a primary specialty of Physician Assistant in Ithaca, NY and a listed phone number of (607) 272-7000.
Profile Overview
- NPI
- 1720785041
- Provider Type
- Individual
- Primary Specialty
- Physician Assistant
- Enumeration Date
- February 08, 2023
- Last Updated
- October 30, 2024
Practice Location
- 16 Brentwood Dr Ste A
- Ithaca, NY 14850-1863
Phone: (607) 272-7000
Specialties
- Physician Assistant (363A00000X)
- Student in an Organized Health Care Education/Training Program (390200000X)
Full Record
- NPI
- 1720785041
- Entity Type
- Individual
- Last Name
- Bush
- First Name
- Madeline
- Middle Name
- Grace
- Mailing Street Address
- 16 Brentwood Dr Ste A
- Mailing City
- Ithaca
- Mailing State
- NY
- Mailing ZIP Code
- 14850-1863
- Mailing Country
- US
- Mailing Phone
- (607) 272-7000
- Practice Street Address
- 16 Brentwood Dr Ste A
- Practice City
- Ithaca
- Practice State
- NY
- Practice ZIP Code
- 14850-1863
- Practice Country
- US
- Practice Phone
- (607) 272-7000
- Enumeration Date
- February 08, 2023
- Last Updated
- October 30, 2024
- Sex
- Female
- Sole Proprietor
- No
- Certification Date
- October 30, 2024
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Physician Assistant (363A00000X), Student in an Organized Health Care Education/Training Program (390200000X)