Graduated: 2020
NPI: 1326743691
Practice Locations (3)
5665 NEW NORTHSIDE DR
ATLANTA, GA 303285834
123 HIGHLAND AVE, SUITE 201
GLEN RIDGE, NJ 070281573
MOUNTAINSIDE MEDICAL CTR, 1 BAY AVENUE/ DEPT OF MEDICINE
MONTCLAIR, NJ 07042
Source: CMS National Downloadable File, September 2026.