Healthcare Provider Details
I. General information
NPI: 1407842248
Provider Name (Legal Business Name): ROBERT JOHN HUGHES MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 09/27/2005
Last Update Date: 10/07/2019
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
400 PATROON CREEK BLVD STE 205
ALBANY NY
12206-5012
US
IV. Provider business mailing address
123 EVERETT RD
ALBANY NY
12205-1407
US
V. Phone/Fax
- Phone: 518-701-2000
- Fax: 518-701-2139
- Phone: 518-701-2000
- Fax: 518-701-2139
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Y00000X |
| Taxonomy | Otolaryngology Physician |
| License Number | 1618791 |
| License Number State | NY |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: