Medical school: VANDERBILT UNIVERSITY SCHOOL OF MEDICINE
Graduated: 1997
Offers telehealth
NPI: 1083718407
Practice Locations (1)
NORTH SHORE-LIJ MEDICAL PC
130 E 77TH ST, 7TH FLOOR BLACK HALL
NEW YORK, NY 100751851
2127448114
Source: CMS National Downloadable File, September 2026.