Graduated: 2020
NPI: 1316544620
Practice Locations (2)
HACKENSACK MERIDIAN HEALTH MEDICAL GROUP - SPECIALTY CARE PC
30 PROSPECT AVE
HACKENSACK, NJ 076011915
HACKENSACK MERIDIAN HEALTH MEDICAL GROUP - SPECIALTY CARE PC
939 KENNEDY BLVD
NORTH BERGEN, NJ 070471870
2018642484
Source: CMS National Downloadable File, September 2026.