Provider Demographics
NPI:1649257700
Name:HUGHES, SANDRA M (MD)
Entity type:Individual
Prefix:
First Name:SANDRA
Middle Name:M
Last Name:HUGHES
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 1:34 PROFFESSIONAL PARK RD
Mailing Address - Street 2:
Mailing Address - City:STORRS MANSFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06268-1659
Mailing Address - Country:US
Mailing Address - Phone:860-487-0002
Mailing Address - Fax:860-429-1663
Practice Address - Street 1:34 PROFFESSIONAL PARK RD
Practice Address - Street 2:
Practice Address - City:STORRS
Practice Address - State:CT
Practice Address - Zip Code:06268-1659
Practice Address - Country:US
Practice Address - Phone:860-487-0002
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-12-29
Last Update Date:2023-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT041911207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
041911OtherCT
0104402OtherUNITED
P3329481OtherOXFORD
CT1499011OtherCIGNA
2V5004OtherHEALTHNET
AETNAOther3550043
CT00141911900Medicaid
CT010041911CT01OtherBCBS
P3329481OtherOXFORD
CT00141911900Medicaid