Basic Information
| Provider Information | |||||||||
| NPI: | 1023083094 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | LAROCCO | ||||||||
| FirstName: | ANTHONY | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | JR. | ||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 301 RIVERVIEW AVE | ||||||||
| Address2: | STE 710 | ||||||||
| City: | NORFOLK | ||||||||
| State: | VA | ||||||||
| PostalCode: | 235101065 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7572529040 | ||||||||
| FaxNumber: | 7572529041 | ||||||||
| Practice Location | |||||||||
| Address1: | 850 KEMPSVILLE RD | ||||||||
| Address2: | STE 100F | ||||||||
| City: | NORFOLK | ||||||||
| State: | VA | ||||||||
| PostalCode: | 235023920 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7572615910 | ||||||||
| FaxNumber: | 7574668317 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/22/2006 | ||||||||
| LastUpdateDate: | 01/18/2017 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 0101047422 | VA | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207RI0200X | 0101047422 | VA | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Infectious Disease |
ID Information
| ID | Type | State | Issuer | Description | PAR | 01 | VA | AETNA | OTHER | PAR | 01 | VA | MULTIPLAN | OTHER | 005852242 | 05 | VA | MEDICAID | PAR | 01 | VA | VIRGINIA PREMIER HEALTH | OTHER | PAR | 01 | VA | USA MANAGED CARE | OTHER | PAR | 01 | VA | CORVEL/CORCARE | OTHER | PAR | 01 | VA | FIRST HEALTH COMMERCIAL/SOUTHERN HEALTH/COVENTRY | OTHER | -032 | 01 | VA | TRICARE/CHAMPUS | OTHER | 8906339 | 05 | NC | MEDICAID | 06339 | 01 | NC | NC BC/BS | OTHER | 38409 | 01 | VA | SENTARA | OTHER | 391454 | 01 | UHC/MAMSI | OTHER | 434034 | 01 | VA | ANTHEM | OTHER | PAR | 01 | VA | CIGNA | OTHER | PAR | 01 | VA | VIRGINIA HEALTH NETWORK | OTHER |