Provider Demographics
NPI:1407842248
Name:HUGHES, ROBERT JOHN (MD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:JOHN
Last Name:HUGHES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:123 EVERETT RD
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12205-1407
Mailing Address - Country:US
Mailing Address - Phone:518-701-2000
Mailing Address - Fax:518-701-2139
Practice Address - Street 1:400 PATROON CREEK BLVD STE 205
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12206-5012
Practice Address - Country:US
Practice Address - Phone:518-701-2000
Practice Address - Fax:518-701-2139
Is Sole Proprietor?:No
Enumeration Date:2005-09-27
Last Update Date:2019-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1618791207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01073032Medicaid
10015751OtherCDHP
141724932002OtherTRICARE
RH037F8010OtherEBS
04114OtherMVP
10015751OtherCDHP
C49829Medicare UPIN
NY33544EMedicare ID - Type Unspecified