Dr. Larissa Sophia Dudley
Emergency Physician
201 Lyons Ave Suite D11
Newark
, New Jersey 07112-2027
Dr. Larissa Sophia Dudley
Emergency Physician
201 Lyons Ave Suite D11
Newark
, New Jersey 07112-2027
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About
Features
Specialties
- Emergency Physician
Languages spoken
- English
Location
First Address
- Dr. Larissa Sophia Dudley
- 3426 41st St Apt 3f
- Long Island City, NY
- Zip : 11101-1351
- Phone :
Second Address
- Dr. Larissa Sophia Dudley
- 201 Lyons Ave Suite D11
- Newark, NJ
- Zip : 07112-2027
- Phone : (973) 926-6671
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207P00000X | Emergency Physician | ME131434 | FL |
National Provider Identifier
| NPI | 1003251422 |
|---|---|
| Provider Name | Dr. Larissa Sophia Dudley |
| First Address | Long Island City, NY 11101-1351 |
| Second Address | Newark, NJ 07112-2027 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 30/04/2013 |
| Last Update Date | 08/12/2017 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.