Graduated: 1987
Offers telehealth
NPI: 1316050552
Practice Locations (3)
279 N SYRACUSE AVE
N MASSAPEQUA, NY 117582027
279 N SYRACUSE AVE
North Massapequa, NY 117582027
279 N SYRACUSE AVE
NORTH MASSAPEQUA, NY 117582027
5169720060
Source: CMS National Downloadable File, September 2026.