Graduated: 2025
NPI: 1417831967
Practice Locations (3)
22414 MERRICK BLVD, SUITE B2ND
LAURELTON, NY 114132023
2050 LAKEVILLE RD, 2 ECM 2ND FLOOR
New Hyde Park, NY 110401639
2050 LAKEVILLE RD, SUITE 2
NEW HYDE PARK, NY 110401639
Source: CMS National Downloadable File, September 2026.