Provider Demographics
NPI:1790186138
Name:HUGHES, MARY
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:
Last Name:HUGHES
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 1:23 CHESTNUT RD
Mailing Address - Street 2:
Mailing Address - City:READING
Mailing Address - State:MA
Mailing Address - Zip Code:01867-2142
Mailing Address - Country:US
Mailing Address - Phone:781-910-7086
Mailing Address - Fax:
Practice Address - Street 1:23 CHESTNUT ROAD
Practice Address - Street 2:
Practice Address - City:READING
Practice Address - State:MA
Practice Address - Zip Code:01867
Practice Address - Country:US
Practice Address - Phone:781-910-7086
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-04
Last Update Date:2014-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2227174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist