Provider Demographics
NPI:1336356872
Name:HUGHES-EAGEN, TIFFANY A (MD)
Entity Type:Individual
Prefix:DR
First Name:TIFFANY
Middle Name:A
Last Name:HUGHES-EAGEN
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 1:326 ADAMS AVE
Mailing Address - Street 2:
Mailing Address - City:SCRANTON
Mailing Address - State:PA
Mailing Address - Zip Code:18503-1668
Mailing Address - Country:US
Mailing Address - Phone:570-348-6100
Mailing Address - Fax:
Practice Address - Street 1:326 ADAMS AVE
Practice Address - Street 2:
Practice Address - City:SCRANTON
Practice Address - State:PA
Practice Address - Zip Code:18503-1604
Practice Address - Country:US
Practice Address - Phone:570-348-6100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-16
Last Update Date:2018-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD073771L2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA050111Medicare UPIN