Graduated: 2015
NPI: 1538509039
Practice Locations (5)
79 -01 BROADWAY
ELMHURST, NY 11373
7901 BROADWAY
ELMHURST, NY 113731329
279 MAIN ST, SUITE 204
NEW PALTZ, NY 125611624
525 W 28TH ST APT, SUITE 865
New York, NY 100016637
1345 RXR PLZ, FL 13
UNIONDALE, NY 115561301
Source: CMS National Downloadable File, September 2026.