Graduated: 2015
NPI: 1437531191
Practice Locations (2)
NORTH SHORE-LIJ MEDICAL PC
100 E 77TH ST
NEW YORK, NY 100751850
2124342140
SOUTHSIDE FACULTY MEDICAL AFFILIATES UNIVERSITY FACULTY PRACTICE CORP
1220 HICKSVILLE RD
SEAFORD, NY 117831604
5162663456
Source: CMS National Downloadable File, September 2026.