Annabella Bushra, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

8536 Issued in NY

Practice address

330 W 58TH St
Suite #504
New York, NY 10019-1827

Phone

(212) 582-7450

Fax

(212) 582-7450

NPI assigned

Feb 12, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Jun 15, 2020 through Jun 15, 2028

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1171238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1477695997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 W 58TH ST",
            "address_2": "SUITE #504",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100191827",
            "telephone_number": "212-582-7450",
            "fax_number": "212-582-7450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 W 58TH ST",
            "address_2": "SUITE #504",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100191827",
            "telephone_number": "212-582-7450",
            "fax_number": "212-582-7450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUSHRA",
        "first_name": "ANNABELLA",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "8536",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sydney C Bush, MD
• Andrea Bushelle, M.D
• Jeannetta Mary Bushey, RN
• Rena Bushman, L.C.S.W.
• Bushra Mina Pulmonary & Critical Care P. C.
• Nushrat Jahan Bushra, CASAC-T
• Kimberly Busi, M.D.
• Kim Busichio, PH.D.
• Tyra Busigo, LMSW
• Christopher Busillo, MD

• Clinical Psychologist in New York, NY
• Providers in New York, NY by specialty
• Clinical Psychologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.