Graduated: 2012
NPI: 1588079602
Practice Locations (2)
STATE OF NEW JERSEY OMB CENTRALIZED PAYROLL
100 SULLIVAN WAY
TRENTON, NJ 086250500
6096331562
ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI
1425 MADISON AVE
NEW YORK, NY 100296514
2128248150
Source: CMS National Downloadable File, September 2026.