Graduated: 2019
NPI: 1316408024
Practice Locations (2)
ST MARYS GENERAL MEDICAL GROUP PC
350 BOULEVARD
PASSAIC, NJ 070552840
9733654300
MPV NEW JERSEY MD SERVICES PC
250 OLD HOOK RD
WESTWOOD, NJ 076753123
2018802700
Source: CMS National Downloadable File, September 2026.