Provider Demographics
NPI:1720123474
Name:UPTON, DARCY K (PT RN)
Entity Type:Individual
Prefix:MS
First Name:DARCY
Middle Name:K
Last Name:UPTON
Suffix:
Gender:F
Credentials:PT RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 SPENCER STREET WEST
Mailing Address - Street 2:
Mailing Address - City:FARMINGDALE
Mailing Address - State:NY
Mailing Address - Zip Code:11735
Mailing Address - Country:US
Mailing Address - Phone:516-384-2037
Mailing Address - Fax:
Practice Address - Street 1:200 BELLE TERRE ROAD
Practice Address - Street 2:ST CHARLES HOSPITAL
Practice Address - City:PORT JEFFERSON
Practice Address - State:NY
Practice Address - Zip Code:11777
Practice Address - Country:US
Practice Address - Phone:631-474-6812
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY322507163W00000X
NY003715225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered163W00000XNursing Service ProvidersRegistered Nurse
Not Answered225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist