Basic Information
Provider Information
NPI: 1821389511
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: DARBOE
FirstName: SULAYMAN
MiddleName: Y
NamePrefix:  
NameSuffix:  
Credential: C.R.N.A.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 3998 FAIR RIDGE DRIVE
Address2: SUITE 300
City: FAIRFAX
State: VA
PostalCode: 22033
CountryCode: US
TelephoneNumber: 7037669737
FaxNumber: 7037669725
Practice Location
Address1: 3600 JOSEPH SIEWICK DR
Address2:  
City: FAIRFAX
State: VA
PostalCode: 220331709
CountryCode: US
TelephoneNumber: 7033913129
FaxNumber: 7032959369
Other Information
ProviderEnumerationDate: 04/28/2011
LastUpdateDate: 04/14/2015
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
367500000X0024169331VAY Physician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered 

No ID Information.


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