1215108287 NPI number — GEORGE B. HUGHES MD FAMILY MEDICINE PLLC

Table of content: (NPI 1215108287)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1215108287 NPI number — GEORGE B. HUGHES MD FAMILY MEDICINE PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
GEORGE B. HUGHES MD FAMILY MEDICINE PLLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1215108287
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/19/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 299
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BURNT HILLS
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
12027-0299
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
518-370-0094
Provider Business Mailing Address Fax Number:
518-377-9258

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
333 KINGSLEY RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BURNT HILLS
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
12027-9509
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
518-370-0094
Provider Business Practice Location Address Fax Number:
518-377-9258
Provider Enumeration Date:
03/18/2008

Additional Information

Authorized Official

Authorized Official Last Name:
HUGHES
Authorized Official First Name:
GEORGE
Authorized Official Middle Name:
BERNARD
Authorized Official Title or Position:
SOLE PROPRIETOR
Authorized Official Telephone Number:
518-370-0094

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X , with the licence number:  186174NN , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 261Q00000X , with the licence number: 186174 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 01270259 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".




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