Most Relevant Information
Provider Data
| NPI Number: | 1003251422 |
| Provider Name: | LARISSA SOPHIA DUDLEY M.D. |
| Entity Type: | Individual |
| Taxonomy Code: | 207P00000X |
| Specialty: | Emergency Medicine |
| License Number: | ME131434 |
Most Important Dates
| Enumeration Date: | 04/30/2013 |
| Last Updated: | 07/02/2024 |
Provider Practice Location
201 LYONS AVE
SUITE D11
NEWARK
NJ
071122027
Practice Location Phone/Fax
| Phone: | 9739266671 |
| Fax: |
Provider Mailing Location
2627 W EAU GALLIE BLVD STE 101
MELBOURNE
FL
329358303
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |