Medical school: UNIVERSITY OF ILLINOIS COLLEGE OF MED (CHI/PEOR/ROCK/CHM-URB)
Graduated: 1991
NPI: 1477882041
Practice Locations (3)
PO BOX
LOS ANGELES, CA 90084
15 GRUMMAN RD W, SUITE 1400
Bethpage, NY 117145029
15 GRUMMAN RD W, SUITE 1400
BETHPAGE, NY 117145029
Source: CMS National Downloadable File, September 2026.