Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208800000X | Urologist | 1439595 | NY |
NPI | 1063405298 |
---|---|
Provider Name | Peter M Hughes |
First Address | Glens Falls, NY 12801-2232 |
Second Address | Glens Falls, NY 12801-2232 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/08/2005 |
Last Update Date | 20/02/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000405963001 | BS (01) | NY |
00972963 | (05) | NY |
10000929 | CDPHP (01) | |
24122 | MVP (01) | NY |
D01779 | (02) | |
PH051E3610 | EBS (01) | NY |