Provider Demographics
NPI:1851391338
Name:HUGHES, ROSE K (OD)
Entity Type:Individual
Prefix:DR
First Name:ROSE
Middle Name:K
Last Name:HUGHES
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 CORNWALL CT
Mailing Address - Street 2:
Mailing Address - City:EAST BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08816-3331
Mailing Address - Country:US
Mailing Address - Phone:732-613-9191
Mailing Address - Fax:732-613-1139
Practice Address - Street 1:4 CORNWALL CT
Practice Address - Street 2:
Practice Address - City:EAST BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08816-3331
Practice Address - Country:US
Practice Address - Phone:732-613-9191
Practice Address - Fax:732-613-1139
Is Sole Proprietor?:No
Enumeration Date:2005-07-27
Last Update Date:2007-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYVUT006105152W00000X
NJ27OA00608700152W00000X
NJ27TO00146000152WV0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
No152WV0400XEye and Vision Services ProvidersOptometristVision Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYU75278Medicare UPIN
NYC57761Medicare ID - Type Unspecified