Organization
SUNWISE DERMATOLOGY & SURGERY LLC
Active
Organization
SUNWISE DERMATOLOGY & SURGERY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JENNIFER LARUSSO DO (OWNER)
(856) 816-2934
Entity
Organization
Contact information
Practice address
102 SLEEPY HOLLOW DR STE 203, MIDDLETOWN, DE 19709-5841
(856) 816-2934
Mailing address
102 SLEEPY HOLLOW DR STE 203, MIDDLETOWN, DE 19709-5841
(856) 816-2934
Taxonomy
Speciality
Code
Description
License number
State
207ND0101X
MOHS-Micrographic Surgery Physician
Primary
2017605796
DE
Other
Enumeration date
08/15/2017
Last updated
07/21/2022
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