Provider Demographics
NPI:1336160993
Name:HUGHES, ELISSA (NP)
Entity Type:Individual
Prefix:
First Name:ELISSA
Middle Name:
Last Name:HUGHES
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:259 MONROE AVE
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14607
Mailing Address - Country:US
Mailing Address - Phone:585-545-7200
Mailing Address - Fax:585-454-2766
Practice Address - Street 1:259 MONROE AVE
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14607
Practice Address - Country:US
Practice Address - Phone:585-545-7200
Practice Address - Fax:585-454-2766
Is Sole Proprietor?:No
Enumeration Date:2006-07-21
Last Update Date:2016-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY334049363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02795444Medicaid
NYJ400052866OtherMEDICARE J100044293
NYJ400040593/GRP70008AMedicare PIN
NYJ400040570/GRPBA0017Medicare PIN