Individual
DR. JENNIFER LYNN LARUSSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
771 E ROUTE 70, SUITE D150, MARLTON, NJ 08053-2352
(856) 569-3393
(856) 596-3394
Mailing address
34 CROWS NEST CT, MOUNT LAUREL, NJ 08054-6109
(856) 273-5811
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
OS013778
PA
207ND0101X
MOHS-Micrographic Surgery Physician
Primary
25MB07507100
NJ
207ND0101X
MOHS-Micrographic Surgery Physician
OS013778
PA
Other
Enumeration date
06/22/2008
Last updated
07/14/2014
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