Medical school: NEW YORK COLLEGE OF OSTEO MEDICINE OF NEW YORK INSTITUTE OF TECHNOLOGY
Graduated: 1985
NPI: 1477645190
Practice Locations (1)
STATE OF NEW JERSEY OMB CENTRALIZED PAYROLL
59 KOCH AVE
MORRIS PLAINS, NJ 079504400
9735381800
Source: CMS National Downloadable File, September 2026.