Provider Demographics
NPI:1821492521
Name:PARDO, HUGUES JR
Entity Type:Individual
Prefix:
First Name:HUGUES
Middle Name:
Last Name:PARDO
Suffix:JR
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 1:1959 FREEMAN
Mailing Address - Street 2:
Mailing Address - City:ELMONT
Mailing Address - State:NY
Mailing Address - Zip Code:11003
Mailing Address - Country:US
Mailing Address - Phone:516-633-4629
Mailing Address - Fax:
Practice Address - Street 1:1959 FREEMAN AVE
Practice Address - Street 2:
Practice Address - City:ELMONT
Practice Address - State:NY
Practice Address - Zip Code:11003-4102
Practice Address - Country:US
Practice Address - Phone:516-633-4629
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-09
Last Update Date:2014-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY319442-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse