Provider Demographics
NPI:1083648570
Name:HUGHES, CAROL
Entity Type:Individual
Prefix:
First Name:CAROL
Middle Name:
Last Name:HUGHES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4310 LONDONDERRY RD
Mailing Address - Street 2:2ND FL
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17109-5300
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:409 S 2ND ST
Practice Address - Street 2:SUITE 3F
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17104-1612
Practice Address - Country:US
Practice Address - Phone:717-230-3459
Practice Address - Fax:717-230-3460
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT010996L2251C2600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251C2600XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistCardiopulmonary
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAPT010996LOtherLICENSE