Provider Demographics
NPI:1639616188
Name:DARBY, REGINALD
Entity Type:Individual
Prefix:
First Name:REGINALD
Middle Name:
Last Name:DARBY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3101 35TH ST NE
Mailing Address - Street 2:APT A
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20018-1659
Mailing Address - Country:US
Mailing Address - Phone:301-440-9862
Mailing Address - Fax:
Practice Address - Street 1:3101 35TH ST NE
Practice Address - Street 2:APT A
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20018-1659
Practice Address - Country:US
Practice Address - Phone:301-440-9862
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-01-23
Last Update Date:2017-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide