Graduated: 2022
NPI: 1205723517
Practice Locations (3)
100 GRANNY RD
FARMINGVILLE, NY 117382873
1377 MOTOR PKWY, SUITE 102
Islandia, NY 117495249
1377 MOTOR PKWY, SUITE 102
ISLANDIA, NY 117495249
Source: CMS National Downloadable File, September 2026.