Provider Demographics
NPI:1992447189
Name:HUGHES KELLY, DIANA JOI (CPT, CPI)
Entity type:Individual
Prefix:MRS
First Name:DIANA
Middle Name:JOI
Last Name:HUGHES KELLY
Suffix:
Gender:F
Credentials:CPT, CPI
Other - Prefix:MS
Other - First Name:DIANA
Other - Middle Name:JOI
Other - Last Name:HUGHES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:73 MARKET ST STE 376
Mailing Address - Street 2:
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10710-7619
Mailing Address - Country:US
Mailing Address - Phone:914-268-8499
Mailing Address - Fax:
Practice Address - Street 1:73 MARKET ST STE 376
Practice Address - Street 2:
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10710-7619
Practice Address - Country:US
Practice Address - Phone:914-268-8499
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-08
Last Update Date:2022-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY20-0440Y13202K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes202K00000XAllopathic & Osteopathic PhysiciansPhlebology