Provider Demographics
NPI:1932764560
Name:DARBY, PAIGE MAGDALENE (MD)
Entity Type:Individual
Prefix:DR
First Name:PAIGE
Middle Name:MAGDALENE
Last Name:DARBY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:ADIRONDACK MEDICAL PRACTICE
Mailing Address - Street 2:3384 NY-22 #3
Mailing Address - City:PERU
Mailing Address - State:NY
Mailing Address - Zip Code:12972
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3384 NY-22 #3
Practice Address - Street 2:
Practice Address - City:PERU
Practice Address - State:NY
Practice Address - Zip Code:12972
Practice Address - Country:US
Practice Address - Phone:518-643-8008
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-09
Last Update Date:2022-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
NY313813207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program