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1295355451

NPI Code Detail

MEDICARE: DR. ERICA BASQUE LAVEY MD

MEDICARE: DR. ERICA BASQUE LAVEY MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician	0101281921	VA
2	207R00000X	Internal Medicine Physician	1023019	MA
3	208000000X	Pediatrics Physician	1023019	MA
4	207R00000X	Internal Medicine Physician	0101281921	VA

General Provider Information

NPI Number	:	1295355451
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ERICA BASQUE LAVEY MD

Provider Business Mailing Address
First Line	:	26 THOMSON PL
Second Line	:
City	:	BOSTON
State	:	MA
Zip	:	02210-1212
Country	:	US
Telephone Number	:	888-663-6331
Fax Number	:

Provider Business Practice Location Address
First Line	:	5460 WESLEYAN DR
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23455-6906
Country	:	US
Telephone Number	:	757-395-1900
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/17/2020
Last Update Date	:	11/18/2025

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Directions to “ DR. ERICA BASQUE LAVEY MD” Practice Location

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