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General NPI Number Information
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NPI Number | 1811923089
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Entity Type | Organization
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Legal Business Name | NORTH COUNTRY ENT, PC
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Dates
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Enumeration Date | 06/23/2006
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Last Update Date | 09/21/2007
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Provider Practice Location Address
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Address Line | 125 MANNIS RD
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City | QUEENSBURY
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State | NY
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Zip | 12804-1365
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Country | US
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Telephone | 518-761-0111
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Fax | 518-761-0111
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Provider Business Mailing Address
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Address Line | 2 MOUNTAIN LEDGE
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City | GANSEVOORT
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State | NY
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Zip | 12831-2539
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Country | US
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Telephone | 518-587-6610
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Fax | 518-226-0890
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Authorized Official
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Title or Position | OWNER/PHYSICIAN
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Name | ROBERT J HUGHES
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Credential | MD
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Telephone | 518-587-6610
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number |
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License Number State |
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