Graduated: 2019
NPI: 1427612795
Practice Locations (2)
REVCORE RECOVERY CENTER OF MANHATTAN LLC
15 2ND AVE, FL 3
BROOKLYN, NY 112152711
9174068744
OPTUM MEDICAL CARE PC
90 S BEDFORD RD
MOUNT KISCO, NY 105493412
9142411050
Source: CMS National Downloadable File, September 2026.