Provider Demographics
NPI:1790013522
Name:HUGO, HONEY BELLE
Entity Type:Individual
Prefix:
First Name:HONEY BELLE
Middle Name:
Last Name:HUGO
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 1:46 WEST SUFFOLK AVE
Mailing Address - Street 2:
Mailing Address - City:CENTRAL ISLIP
Mailing Address - State:NY
Mailing Address - Zip Code:11722-1785
Mailing Address - Country:US
Mailing Address - Phone:631-761-6655
Mailing Address - Fax:631-761-6051
Practice Address - Street 1:46 WEST SUFFOLK AVE
Practice Address - Street 2:
Practice Address - City:CENTRAL ISLIP
Practice Address - State:NY
Practice Address - Zip Code:11722-3626
Practice Address - Country:US
Practice Address - Phone:631-761-6655
Practice Address - Fax:631-761-6051
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-07
Last Update Date:2016-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY031328171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor