Provider Demographics
NPI:1558305144
Name:HUGHES, ILA G (RPA-C)
Entity Type:Individual
Prefix:
First Name:ILA
Middle Name:G
Last Name:HUGHES
Suffix:
Gender:F
Credentials:RPA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6565 FOURTH SECTION RD
Mailing Address - Street 2:SUITE 500
Mailing Address - City:BROCKPORT
Mailing Address - State:NY
Mailing Address - Zip Code:14420-2414
Mailing Address - Country:US
Mailing Address - Phone:585-637-2670
Mailing Address - Fax:585-637-3678
Practice Address - Street 1:6565 FOURTH SECTION RD
Practice Address - Street 2:SUITE 500
Practice Address - City:BROCKPORT
Practice Address - State:NY
Practice Address - Zip Code:14420-2414
Practice Address - Country:US
Practice Address - Phone:585-637-2670
Practice Address - Fax:585-637-3678
Is Sole Proprietor?:No
Enumeration Date:2006-06-15
Last Update Date:2023-07-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY1369207V00000X
NY001369363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02108712Medicaid
S53341Medicare UPIN
NY02108712Medicaid
NYBB6222-GRP: 70008AMedicare PIN