Graduated: 1995
NPI: 1316218399
Practice Locations (2)
SOUTHSIDE FACULTY MEDICAL AFFILIATES UNIVERSITY FACULTY PRACTICE CORP
1421 3RD AVE
NEW YORK, NY 100281899
2127445538
NORTH SHORE-LIJ MEDICAL PC
1300 ROANOKE AVE
RIVERHEAD, NY 119012031
6315486000
Source: CMS National Downloadable File, September 2026.