Provider Demographics
NPI:1265794366
Name:CUEVAS, PENELOPE HUGGINS (MD)
Entity type:Individual
Prefix:
First Name:PENELOPE
Middle Name:HUGGINS
Last Name:CUEVAS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13 TALON DR
Mailing Address - Street 2:
Mailing Address - City:SCHENECTADY
Mailing Address - State:NY
Mailing Address - Zip Code:12309-1840
Mailing Address - Country:US
Mailing Address - Phone:212-203-6454
Mailing Address - Fax:
Practice Address - Street 1:13 TALON DR
Practice Address - Street 2:
Practice Address - City:SCHENECTADY
Practice Address - State:NY
Practice Address - Zip Code:12309-1840
Practice Address - Country:US
Practice Address - Phone:212-203-6454
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-13
Last Update Date:2016-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2734492083C0008X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083C0008XAllopathic & Osteopathic PhysiciansPreventive MedicineClinical Informatics
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program