Basic Information
| Provider Information | |||||||||
| NPI: | 1912968470 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HUGHES | ||||||||
| FirstName: | RENA | ||||||||
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| Credential: | P.T. | ||||||||
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| OtherLastName: | HARRINGTON | ||||||||
| OtherFirstName: | RENA | ||||||||
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| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 231 WALTON ST | ||||||||
| Address2: | SUITE 200 | ||||||||
| City: | SYRACUSE | ||||||||
| State: | NY | ||||||||
| PostalCode: | 132021230 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3154780380 | ||||||||
| FaxNumber: | 3154780388 | ||||||||
| Practice Location | |||||||||
| Address1: | 91 PERIMETER RD | ||||||||
| Address2: | SUITE 160 | ||||||||
| City: | ROME | ||||||||
| State: | NY | ||||||||
| PostalCode: | 134414018 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3153363480 | ||||||||
| FaxNumber: | 3153363482 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/31/2006 | ||||||||
| LastUpdateDate: | 09/23/2008 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | 023975 | NY | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.