Individual
MIRJA LAROCHE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3600 JOSEPH SIEWICK DR, ANESTHESIA DEPT, FAIRFAX, VA 22033-1709
(703) 391-3129
(703) 295-9369
Mailing address
68 S SERVICE RD, SUITE 350, MELVILLE, NY 11747
(516) 945-3107
(516) 945-3131
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
0101249195
VA
207L00000X
Anesthesiology Physician
2774281
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1780846113
—
VA
01
—
303887
KAISER
VA
01
—
K142-0001
CARE FIRST
DC
Enumeration date
06/26/2008
Last updated
03/31/2016
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