Provider Demographics
NPI:1073652996
Name:DARBY, JAMES (LMT)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:
Last Name:DARBY
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1680 EMPIRE BLVD
Mailing Address - Street 2:STE 200
Mailing Address - City:WEBSTER
Mailing Address - State:NY
Mailing Address - Zip Code:14580-2130
Mailing Address - Country:US
Mailing Address - Phone:585-787-1841
Mailing Address - Fax:
Practice Address - Street 1:1680 EMPIRE BLVD
Practice Address - Street 2:STE 200
Practice Address - City:WEBSTER
Practice Address - State:NY
Practice Address - Zip Code:14580-2130
Practice Address - Country:US
Practice Address - Phone:585-787-1841
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011696-1174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY152538GGOtherPREFERRED CARE