Graduated: 1987
NPI: 1245214832
Practice Locations (2)
NORTH SHORE-LIJ MEDICAL PC
100 E 77TH ST
NEW YORK, NY 100751850
2124342140
SOUTHSIDE FACULTY MEDICAL AFFILIATES UNIVERSITY FACULTY PRACTICE CORP
1421 3RD AVE
NEW YORK, NY 100281899
2127445538
Source: CMS National Downloadable File, September 2026.