Medical school: RUTGERS NEW JERSEY MEDICAL SCHOOL
Graduated: 1975
NPI: 1255518205
Practice Locations (2)
120 PROSPECT AVE
HACKENSACK, NJ 076012256
2014880707
120 PROSPECT AVE, TOP FLOOR
HACKENSACK, NJ 076012256
Source: CMS National Downloadable File, September 2026.