Graduated: 2005
NPI: 1619105483
Practice Locations (4)
1065 SOUTHERN BLVD
Bronx, NY 104592417
1065 SOUTHERN BLVD
BRONX, NY 104592417
1345 AVE OF THE AMERICAS FL, SUITE 8
NEW YORK, NY 101050018
1345 RXR PLZ
UNIONDALE, NY 115561301
Source: CMS National Downloadable File, September 2026.