Graduated: 1992
Offers telehealth
NPI: 1063407054
Practice Locations (3)
6724 165TH ST
Fresh Meadows, NY 113653204
67-24 165TH STREET
FRESH MEADOWS, NY 113653204
7184634640
6724 165TH ST
FRESH MEADOWS, NY 113653204
Source: CMS National Downloadable File, September 2026.