Graduated: 1990
NPI: 1467560656
Practice Locations (5)
112 -14 CORONA AVE
CORONA, NY 113684022
7184410184
10030 DITMARS BLVD
EAST ELMHURST, NY 113691333
7184410184
83 -05 GRAND AVE
ELMHURST, NY 113734104
7184410184
61 80 WOODHAVEN BLVD
REGO PARK, NY 113742742
7184410184
11903 101ST AVE
SOUTH RICHMOND HILL, NY 114191322
7184410184
Source: CMS National Downloadable File, September 2026.