Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223S0112X | Oral and Maxillofacial Surgeon | 019027260 | IL |
NPI | 1104082494 |
---|---|
Provider Name | Dr. Ted Albert Hughes |
First Address | East Meadow, NY 11554-1151 |
Second Address | East Meadow, NY 11554-1859 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/08/2008 |
Last Update Date | 06/08/2008 |