Provider Demographics
NPI:1417279035
Name:PAYNE, ADAM JOHN (PA-C)
Entity type:Individual
Prefix:MR
First Name:ADAM
Middle Name:JOHN
Last Name:PAYNE
Suffix:
Gender:
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:969 MAIN ST STE D
Mailing Address - Street 2:
Mailing Address - City:FISHKILL
Mailing Address - State:NY
Mailing Address - Zip Code:12524-1791
Mailing Address - Country:US
Mailing Address - Phone:845-896-7730
Mailing Address - Fax:845-896-7758
Practice Address - Street 1:969 MAIN ST STE D
Practice Address - Street 2:
Practice Address - City:FISHKILL
Practice Address - State:NY
Practice Address - Zip Code:12524-1791
Practice Address - Country:US
Practice Address - Phone:845-896-7730
Practice Address - Fax:845-896-7758
Is Sole Proprietor?:No
Enumeration Date:2010-02-23
Last Update Date:2025-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY028346363A00000X, 207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No207N00000XAllopathic & Osteopathic PhysiciansDermatology