Healthcare Provider Details

I. General information

NPI: 1831414010
Provider Name (Legal Business Name): DARLENE A. DAMES RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/31/2010
Last Update Date: 08/03/2023
Certification Date: 08/01/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5 LAKE ST
STAMFORD NY
12167-1007
US

IV. Provider business mailing address

1 RICE MOUNTAIN PL
TROY NY
12182
US

V. Phone/Fax

Practice location:
  • Phone: 607-652-3675
  • Fax: 607-652-6767
Mailing address:
  • Phone: 518-330-5600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number040234
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: