Provider Demographics
NPI:1225017296
Name:HUGHES, KATHRYN ANN (MD)
Entity Type:Individual
Prefix:
First Name:KATHRYN
Middle Name:ANN
Last Name:HUGHES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:100 KINGS HWY S
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14617-5504
Mailing Address - Country:US
Mailing Address - Phone:585-922-4518
Mailing Address - Fax:585-922-3950
Practice Address - Street 1:1415 PORTLAND AVE STE 245
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14621-3022
Practice Address - Country:US
Practice Address - Phone:585-922-4518
Practice Address - Fax:585-922-3950
Is Sole Proprietor?:No
Enumeration Date:2006-01-10
Last Update Date:2020-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY307230208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA011921Medicaid
MA011921Medicaid
G39114Medicare UPIN