Graduated: 2012
NPI: 1093133134
Practice Locations (2)
NORTHEAST MEDICAL GROUP INC
267 GRANT ST
BRIDGEPORT, CT 066102805
2033843000
JEWISH HOME LIFECARE, MANHATTAN
120 W 106TH ST
NEW YORK, NY 100253923
21287050005759
Source: CMS National Downloadable File, September 2026.