Graduated: 1984
NPI: 1346270667
Practice Locations (2)
SOUTHSIDE FACULTY MEDICAL AFFILIATES UNIVERSITY FACULTY PRACTICE CORP
9525 QUEENS BLVD
REGO PARK, NY 113744510
7183605522
NORTH SHORE-LIJ MEDICAL PC
1 HEROES WAY
RIVERHEAD, NY 119012054
6315486000
Source: CMS National Downloadable File, September 2026.