Medical school: UNIVERSITY OF NORTH CAROLINA AT CHAPEL HILL SCHOOL OF MEDICINE
Graduated: 1980
NPI: 1003914680
Practice Locations (2)
10 B MEDICAL DR
PORT JEFFERSON STATION, NY 117761590
10 MEDICAL DR, SUITE B
PORT JEFFERSON STATION, NY 117761590
6314741111
Source: CMS National Downloadable File, September 2026.