Graduated: 2001
NPI: 1407611072
Practice Locations (2)
MILL BASIN MEDICAL HEALTH PC
1583 E 66TH ST, FL 1
BROOKLYN, NY 112346005
6462961508
MEDICAL SERVICES OF NORTHEASTERN QUEENS PLLC
9131 175TH ST
JAMAICA, NY 114325517
7186576363
Source: CMS National Downloadable File, September 2026.