Medical school: STATE UNIVERSITY OF NEW YORK - STATE COLLEGE OPTOMETRY
Graduated: 2001
NPI: 1609843341
Practice Locations (2)
2222 MORRIS AVE, SUITE 1
UNION, NJ 070835911
9089642130
STATE OF NEW YORK COMPTROLLERS OFFICE
33 W 42ND ST
NEW YORK, NY 100368005
2129384001
Source: CMS National Downloadable File, September 2026.