Graduated: 1981
NPI: 1265495980
Practice Locations (2)
HACKENSACK MERIDIAN HEALTH MEDICAL GROUP - SPECIALTY CARE PC
1030 SAINT GEORGES AVE
AVENEL, NJ 070011330
HACKENSACK MERIDIAN HEALTH MEDICAL GROUP - SPECIALTY CARE PC
30 PROSPECT AVE
HACKENSACK, NJ 076011915
Source: CMS National Downloadable File, September 2026.