Medical school: STATE UNIVERSITY OF NY UPSTATE MEDICAL UNIVERSITY
Graduated: 1978
NPI: 1568504322
Practice Locations (3)
3053 MIDDLE COUNTRY RD
LAKE GROVE, NY 117552109
6314730454
102 PROSPECT ST
Port Jefferson, NY 117771813
102 PROSPECT ST
PORT JEFFERSON, NY 117771813
6314730454
Source: CMS National Downloadable File, September 2026.