Provider Demographics
NPI:1851405542
Name:LAROSA, KATHLEEN (MD)
Entity Type:Individual
Prefix:DR
First Name:KATHLEEN
Middle Name:
Last Name:LAROSA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:9900 INDEPENDENCE PARK DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23233-1473
Mailing Address - Country:US
Mailing Address - Phone:804-747-1855
Mailing Address - Fax:804-762-8837
Practice Address - Street 1:7347 BELL CREEK RD
Practice Address - Street 2:SUITE 100
Practice Address - City:MECHANICSVILLE
Practice Address - State:VA
Practice Address - Zip Code:23111-3504
Practice Address - Country:US
Practice Address - Phone:804-559-9430
Practice Address - Fax:804-559-2037
Is Sole Proprietor?:No
Enumeration Date:2006-08-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101-228199208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
179108OtherANTHEM
297629OtherSOUTHERN HEALTH