Graduated: 2000
NPI: 1578791745
Practice Locations (2)
NORTHEAST MEDICAL GROUP INC
267 GRANT ST
BRIDGEPORT, CT 066102805
2033843000
PRACTICE ASSOCIATES MEDICAL GROUP
97 W PKWY, 2ND FLOOR
POMPTON PLAINS, NJ 074441647
9738315063
Source: CMS National Downloadable File, September 2026.