Graduated: 1995
NPI: 1013088509
Practice Locations (4)
835 MAIN ST
HACKENSACK, NJ 076014812
PO BOX, SUITE 924
MAYWOOD, NJ 07607
6603 FRESH POND RD
Ridgewood, NY 113853310
6603 FRESH POND RD
RIDGEWOOD, NY 113853310
Source: CMS National Downloadable File, September 2026.