Medical school: STATE UNIVERSITY OF NEW YORK AT STONY BROOK, SCHOOL OF MEDICINE
Graduated: 2006
NPI: 1528380151
Practice Locations (1)
NORTH SHORE-LIJ MEDICAL PC
1 W EXCHANGE ST, UNIT 2404
PROVIDENCE, RI 029031079
5164057080
Source: CMS National Downloadable File, September 2026.