Graduated: 2023
NPI: 1104513662
Practice Locations (4)
3249 KINGSBRIDGE AVE
BRONX, NY 104635514
615 W 143RD ST APT, SUITE 61
New York, NY 100315900
615 W 143RD ST, APT 61
NEW YORK, NY 100315900
7 W 30TH ST FLOOR, SUITE 9
NEW YORK, NY 100014407
Source: CMS National Downloadable File, September 2026.