Provider Demographics
NPI:1215108287
Name:GEORGE B. HUGHES MD FAMILY MEDICINE PLLC
Entity type:Organization
Organization Name:GEORGE B. HUGHES MD FAMILY MEDICINE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE PROPRIETOR
Authorized Official - Prefix:DR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:BERNARD
Authorized Official - Last Name:HUGHES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:518-370-0094
Mailing Address - Street 1:PO BOX 299
Mailing Address - Street 2:
Mailing Address - City:BURNT HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:12027-0299
Mailing Address - Country:US
Mailing Address - Phone:518-370-0094
Mailing Address - Fax:518-377-9258
Practice Address - Street 1:333 KINGSLEY RD
Practice Address - Street 2:
Practice Address - City:BURNT HILLS
Practice Address - State:NY
Practice Address - Zip Code:12027-9509
Practice Address - Country:US
Practice Address - Phone:518-370-0094
Practice Address - Fax:518-377-9258
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-18
Last Update Date:2019-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY186174NN207Q00000X
NY186174261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
No261Q00000XAmbulatory Health Care FacilitiesClinic/CenterGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01270259Medicaid
NYBA1394Medicare PIN