Graduated: 2001
NPI: 1477593820
Practice Locations (2)
HACKENSACK MERIDIAN HEALTH MEDICAL GROUP - SPECIALTY CARE PC
30 PROSPECT AVE
HACKENSACK, NJ 076011915
HACKENSACK MERIDIAN HEALTH MEDICAL GROUP - SPECIALTY CARE PC
113 W ESSEX ST, SUITE 201
MAYWOOD, NJ 076071023
2012517725
Source: CMS National Downloadable File, September 2026.