Provider Demographics
NPI:1982711776
Name:HUGHES, DORIS (FNP)
Entity type:Individual
Prefix:MS
First Name:DORIS
Middle Name:
Last Name:HUGHES
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:MS
Other - First Name:DORIS
Other - Middle Name:
Other - Last Name:MICHALOVIC
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP
Mailing Address - Street 1:169 RIVERSIDE DR
Mailing Address - Street 2:
Mailing Address - City:BINGHAMTON
Mailing Address - State:NY
Mailing Address - Zip Code:13905-4246
Mailing Address - Country:US
Mailing Address - Phone:607-772-6269
Mailing Address - Fax:607-798-6164
Practice Address - Street 1:169 RIVERSIDE DR
Practice Address - Street 2:
Practice Address - City:BINGHAMTON
Practice Address - State:NY
Practice Address - Zip Code:13905-4246
Practice Address - Country:US
Practice Address - Phone:607-772-6269
Practice Address - Fax:607-798-6164
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-25
Last Update Date:2009-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF332531363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYRB1201Medicare PIN