Provider Demographics
NPI:1720054380
Name:HUGHES, GEORGE B (MD)
Entity Type:Individual
Prefix:
First Name:GEORGE
Middle Name:B
Last Name:HUGHES
Suffix:
Gender:M
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:PO BOX 299
Mailing Address - Street 2:
Mailing Address - City:BURNT HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:12027-0299
Mailing Address - Country:US
Mailing Address - Phone:518-370-0094
Mailing Address - Fax:518-377-9258
Practice Address - Street 1:333 KINGSLEY RD
Practice Address - Street 2:
Practice Address - City:BURNT HILLS
Practice Address - State:NY
Practice Address - Zip Code:12027-9509
Practice Address - Country:US
Practice Address - Phone:518-370-0094
Practice Address - Fax:518-377-9258
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-24
Last Update Date:2019-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY186174-1207Q00000X
NY186174207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01270259Medicaid
NYE94507Medicare UPIN
NYRA5807Medicare ID - Type Unspecified
NY331833Medicare Oscar/Certification
NY01270259Medicaid