Healthcare Provider Details

I. General information

NPI: 1932764560
Provider Name (Legal Business Name): PAIGE MAGDALENE DARBY MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/09/2019
Last Update Date: 06/17/2022
Certification Date: 06/14/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3384 NY-22 #3
PERU NY
12972
US

IV. Provider business mailing address

ADIRONDACK MEDICAL PRACTICE 3384 NY-22 #3
PERU NY
12972
US

V. Phone/Fax

Practice location:
  • Phone: 518-643-8008
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number313813
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: