Healthcare Provider Details

I. General information

NPI: 1720054380
Provider Name (Legal Business Name): GEORGE B. HUGHES M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/24/2006
Last Update Date: 07/19/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

333 KINGSLEY RD
BURNT HILLS NY
12027-9509
US

IV. Provider business mailing address

PO BOX 299
BURNT HILLS NY
12027-0299
US

V. Phone/Fax

Practice location:
  • Phone: 518-370-0094
  • Fax: 518-377-9258
Mailing address:
  • Phone: 518-370-0094
  • Fax: 518-377-9258

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number186174-1
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number186174
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: