Medical school: STATE UNIVERSITY OF NY UPSTATE MEDICAL UNIVERSITY
Graduated: 1986
NPI: 1366446262
Practice Locations (2)
4302 MEDICAL CTR DR, SUITE 302
FAYETTEVILLE, NY 130666625
3154239722
1101 NOTT ST
SCHENECCTADY, NY 123082425
5182434000
Source: CMS National Downloadable File, September 2026.