Graduated: 2010
NPI: 1588985964
Practice Locations (2)
NORTH SHORE-LIJ MEDICAL PC
256 MASON AVE, BLDG C
STATEN ISLAND, NY 103053408
7182266969
NORTH SHORE HEALTH SYSTEM MEDICAL FACULTY GROUP PRACTICE INC
256 MASON AVE, C
STATEN ISLAND, NY 103053408
7182266400
Source: CMS National Downloadable File, September 2026.