Graduated: 1974
NPI: 1053414318
Practice Locations (2)
NORTH SHORE-LIJ MEDICAL PC
10201 66TH RD
FOREST HILLS, NY 113752029
7188304000
SOUTHSIDE FACULTY MEDICAL AFFILIATES UNIVERSITY FACULTY PRACTICE CORP
9525 QUEENS BLVD
REGO PARK, NY 113744510
7183605522
Source: CMS National Downloadable File, September 2026.