Healthcare Provider Details

I. General information

NPI: 1295355451
Provider Name (Legal Business Name): ERICA BASQUE LAVEY MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ERICA MICHELE BASQUE

II. Dates (important events)

Enumeration Date: 04/17/2020
Last Update Date: 10/09/2026
Certification Date: 10/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8401 CONNECTICUT AVE PH STE
CHEVY CHASE MD
20815-5822
US

IV. Provider business mailing address

8401 CONNECTICUT AVE PH STE
CHEVY CHASE MD
20815-5822
US

V. Phone/Fax

Practice location:
  • Phone: 888-663-6331
  • Fax:
Mailing address:
  • Phone: 888-663-6331
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number1023019
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberD0108000
License Number StateMD
# 3
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number0101281921
License Number StateVA
# 4
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number1023019
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: