Graduated: 2025
NPI: 1467266460
Practice Locations (4)
1276 FULTON AVE, RM 219
BRONX, NY 104563499
1650 GRAND CONCOURSE
BRONX, NY 104577679
1650 GRAND CONCOURSE
BRONX, NY 104577697
300 E 39TH ST APT, 23E
New York, NY 100162215
Source: CMS National Downloadable File, September 2026.