Healthcare Provider Details

I. General information

NPI: 1992783690
Provider Name (Legal Business Name): THOMAS JAMES LAVEY PARAMEDIC / HS1
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 01/04/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 E MAIN ST SUITE #1000
NORFOLK VA
23510-1753
US

IV. Provider business mailing address

3408 HOLLYGREEN DR APT. #102
VIRGINIA BEACH VA
23452-4880
US

V. Phone/Fax

Practice location:
  • Phone: 757-628-4351
  • Fax: 757-628-4337
Mailing address:
  • Phone: 757-463-1484
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code146L00000X
TaxonomyParamedic
License Number
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: