Provider Demographics
NPI:1811685332
Name:DARNELL, TARIQ J
Entity type:Individual
Prefix:
First Name:TARIQ
Middle Name:J
Last Name:DARNELL
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 1:1420 PACIFIC AVE
Mailing Address - Street 2:
Mailing Address - City:CAPITOL HEIGHTS
Mailing Address - State:MD
Mailing Address - Zip Code:20743-5311
Mailing Address - Country:US
Mailing Address - Phone:202-595-5616
Mailing Address - Fax:
Practice Address - Street 1:1420 PACIFIC AVE
Practice Address - Street 2:
Practice Address - City:CAPITOL HEIGHTS
Practice Address - State:MD
Practice Address - Zip Code:20743-5311
Practice Address - Country:US
Practice Address - Phone:202-595-5616
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-25
Last Update Date:2023-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide