Provider Demographics
NPI:1023083094
Name:LAROCCO, ANTHONY JR (MD)
Entity type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:
Last Name:LAROCCO
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 RIVERVIEW AVE
Mailing Address - Street 2:STE 710
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23510-1065
Mailing Address - Country:US
Mailing Address - Phone:757-252-9040
Mailing Address - Fax:757-252-9041
Practice Address - Street 1:850 KEMPSVILLE RD
Practice Address - Street 2:STE 100F
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23502-3920
Practice Address - Country:US
Practice Address - Phone:757-261-5910
Practice Address - Fax:757-466-8317
Is Sole Proprietor?:No
Enumeration Date:2006-02-22
Last Update Date:2017-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101047422207R00000X, 207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAPAROtherAETNA
VAPAROtherMULTIPLAN
VA005852242Medicaid
VAPAROtherVIRGINIA PREMIER HEALTH
VAPAROtherUSA MANAGED CARE
VAPAROtherCORVEL/CORCARE
VAPAROtherFIRST HEALTH COMMERCIAL/SOUTHERN HEALTH/COVENTRY
VA-032OtherTRICARE/CHAMPUS
NC8906339Medicaid
NC06339OtherNC BC/BS
VA38409OtherSENTARA
391454OtherUHC/MAMSI
VA434034OtherANTHEM
VAPAROtherCIGNA
VAPAROtherVIRGINIA HEALTH NETWORK
VA38409OtherSENTARA
VA110219734Medicare PIN
VAPAROtherCIGNA