Provider Demographics
NPI:1689973885
Name:HUESTON, KEVIN P
Entity Type:Individual
Prefix:MR
First Name:KEVIN
Middle Name:P
Last Name:HUESTON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 378
Mailing Address - Street 2:
Mailing Address - City:WASHINGTONVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:10992-0378
Mailing Address - Country:US
Mailing Address - Phone:718-670-7352
Mailing Address - Fax:866-522-9101
Practice Address - Street 1:1511 BANTAM PL
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10469-5928
Practice Address - Country:US
Practice Address - Phone:718-670-7352
Practice Address - Fax:866-522-9101
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-28
Last Update Date:2012-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies