Graduated: 1982
NPI: 1285657312
Practice Locations (4)
120 WOODBINE AVE
Northport, NY 117682897
120 WOODBINE AVE 1ST FLOOR
Northport, NY 117682897
120 WOODBINE AVE
NORTHPORT, NY 117682897
120 WOODBINE AVE, APT 1
NORTHPORT, NY 117682897
6312626900
Source: CMS National Downloadable File, September 2026.