Provider Demographics
NPI:1437360781
Name:DARBY NUTRITION-DIETETICS PRACTICE PLLC
Entity Type:Organization
Organization Name:DARBY NUTRITION-DIETETICS PRACTICE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PAMELLA
Authorized Official - Middle Name:
Authorized Official - Last Name:DARBY
Authorized Official - Suffix:
Authorized Official - Credentials:MS, RD
Authorized Official - Phone:917-546-6636
Mailing Address - Street 1:225 EAST 74 ST
Mailing Address - Street 2:#2L
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021
Mailing Address - Country:US
Mailing Address - Phone:917-546-6636
Mailing Address - Fax:917-546-6655
Practice Address - Street 1:225 EAST 74 ST
Practice Address - Street 2:#2L
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021
Practice Address - Country:US
Practice Address - Phone:917-546-6636
Practice Address - Fax:917-546-6655
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-25
Last Update Date:2011-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY476792420133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty