Graduated: 1988
NPI: 1306830658
Practice Locations (2)
HAVEN BEHAVIORAL SERVICES OF PHILADELPHIA, LLC
3300 HENRY AVE, UNIT 4
PHILADELPHIA, PA 191291141
2154753400
EASTERN PENNSYLVANIA PHYSICIAN ALLIANCE, LLC
4641 ROOSEVELT BLVD
PHILADELPHIA, PA 191242343
2158314600
Source: CMS National Downloadable File, September 2026.