Graduated: 1985
NPI: 1588756514
Practice Locations (2)
NORTH SHORE-LIJ MEDICAL PC
300 COMMUNITY DR
MANHASSET, NY 110303816
5165623590
SOUTHSIDE FACULTY MEDICAL AFFILIATES UNIVERSITY FACULTY PRACTICE CORP
9525 QUEENS BLVD
REGO PARK, NY 113744510
7183605522
Source: CMS National Downloadable File, September 2026.