Provider Demographics
NPI:1831451160
Name:HUGHES, DEBERA JEAN (MS)
Entity type:Individual
Prefix:
First Name:DEBERA
Middle Name:JEAN
Last Name:HUGHES
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:134 E MADISON ST
Mailing Address - Street 2:
Mailing Address - City:EAST ISLIP
Mailing Address - State:NY
Mailing Address - Zip Code:11730-1614
Mailing Address - Country:US
Mailing Address - Phone:516-406-1687
Mailing Address - Fax:
Practice Address - Street 1:134 E MADISON ST
Practice Address - Street 2:
Practice Address - City:EAST ISLIP
Practice Address - State:NY
Practice Address - Zip Code:11730-1614
Practice Address - Country:US
Practice Address - Phone:516-406-1687
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-12
Last Update Date:2012-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist