Provider Demographics
NPI:1306867221
Name:DARBY ENTERPRISE GROUP LLC
Entity Type:Organization
Organization Name:DARBY ENTERPRISE GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:
Authorized Official - Last Name:DARBY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:518-899-4202
Mailing Address - Street 1:2381 ROUTE 9 STE 1
Mailing Address - Street 2:
Mailing Address - City:MECHANICVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:12118-3901
Mailing Address - Country:US
Mailing Address - Phone:518-899-4202
Mailing Address - Fax:518-899-4206
Practice Address - Street 1:2381 ROUTE 9 STE 1
Practice Address - Street 2:
Practice Address - City:MECHANICVILLE
Practice Address - State:NY
Practice Address - Zip Code:12118-3901
Practice Address - Country:US
Practice Address - Phone:518-899-4202
Practice Address - Fax:518-899-4206
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY=========OtherTAX ID NUMBER
NY5684470001Medicare ID - Type UnspecifiedMEDICARE