Provider Demographics
NPI:1366413858
Name:RUSH, STEPHEN H (DC)
Entity type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:H
Last Name:RUSH
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:75 FILORS LN
Mailing Address - Street 2:
Mailing Address - City:STONY POINT
Mailing Address - State:NY
Mailing Address - Zip Code:10980-2743
Mailing Address - Country:US
Mailing Address - Phone:845-947-7874
Mailing Address - Fax:845-786-0030
Practice Address - Street 1:75 FILORS LN
Practice Address - Street 2:
Practice Address - City:STONY POINT
Practice Address - State:NY
Practice Address - Zip Code:10980-2743
Practice Address - Country:US
Practice Address - Phone:845-947-7874
Practice Address - Fax:845-786-0030
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX006239-1111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
382081OtherAMERICAN SPECIALTY HEALTH
817973OtherMPN
P2552208OtherOXFORD
4404358OtherAETNA
382207OtherACN GROUP
5801231OtherGHI
NYX67041OtherEMPIRE BC/BS
P2552208OtherOXFORD
4404358OtherAETNA