Healthcare Provider Details

I. General information

NPI: 1114201829
Provider Name (Legal Business Name): DARLYS A. FORBES RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/30/2011
Last Update Date: 09/30/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1638 COUNTY ROUTE 45
FULTON NY
13069-4444
US

IV. Provider business mailing address

67 SPRING ST
MEXICO NY
13114-3484
US

V. Phone/Fax

Practice location:
  • Phone: 315-963-8400
  • Fax:
Mailing address:
  • Phone: 315-963-8861
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License Number4624731
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: