Graduated: 2015
NPI: 1043697238
Practice Locations (2)
NORTHEAST MEDICAL GROUP INC
267 GRANT ST
BRIDGEPORT, CT 066102805
2033843000
ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI
1 GUSTAVE L LEVY PL
NEW YORK, NY 100296504
2126588552
Source: CMS National Downloadable File, September 2026.