Provider Demographics
NPI:1013193382
Name:MCHUGH, BRIAN JEFFREY (MD)
Entity Type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:JEFFREY
Last Name:MCHUGH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1175 MONTAUK HWY STE 6
Mailing Address - Street 2:
Mailing Address - City:WEST ISLIP
Mailing Address - State:NY
Mailing Address - Zip Code:11795-4939
Mailing Address - Country:US
Mailing Address - Phone:833-774-6333
Mailing Address - Fax:516-433-1036
Practice Address - Street 1:1175 MONTAUK HWY STE 6
Practice Address - Street 2:
Practice Address - City:WEST ISLIP
Practice Address - State:NY
Practice Address - Zip Code:11795-4939
Practice Address - Country:US
Practice Address - Phone:833-774-6333
Practice Address - Fax:516-433-1036
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-16
Last Update Date:2019-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
VA0101258412207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program