Medical school: STATE UNIVERSITY OF NEW YORK DOWNSTATE MEDICAL CENTER
Graduated: 1986
NPI: 1164513354
Practice Locations (2)
20 -00 FAIR LAWN AVE
FAIR LAWN, NJ 074102319
2017946000
1468 RICHMOND AVE
STATEN ISLAND, NY 103141550
7184946699
Source: CMS National Downloadable File, September 2026.