Provider Demographics
NPI:1194586487
Name:SUNRISE THERAPEUTICS CORP
Entity type:Organization
Organization Name:SUNRISE THERAPEUTICS CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DO/AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:D
Authorized Official - Last Name:HART
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:516-459-4671
Mailing Address - Street 1:4200 SUNRISE HWY
Mailing Address - Street 2:
Mailing Address - City:MASSAPEQUA
Mailing Address - State:NY
Mailing Address - Zip Code:11758-5311
Mailing Address - Country:US
Mailing Address - Phone:516-980-1656
Mailing Address - Fax:516-798-9070
Practice Address - Street 1:4200 SUNRISE HWY
Practice Address - Street 2:
Practice Address - City:MASSAPEQUA
Practice Address - State:NY
Practice Address - Zip Code:11758-5311
Practice Address - Country:US
Practice Address - Phone:516-980-1656
Practice Address - Fax:516-798-9070
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-23
Last Update Date:2024-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies