Healthcare Provider Details

I. General information

NPI: 1114244928
Provider Name (Legal Business Name): DARREN LEONARD BAZINI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/03/2010
Last Update Date: 01/02/2026
Certification Date: 01/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1850 TOWN CENTER PKWY
RESTON VA
20190-3204
US

IV. Provider business mailing address

607 HERNDON PKWY STE 101
HERNDON VA
20170-5477
US

V. Phone/Fax

Practice location:
  • Phone: 516-983-2565
  • Fax:
Mailing address:
  • Phone: 703-471-0919
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number0101263465
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: