Graduated: 1987
NPI: 1649259383
Practice Locations (3)
STATE OF NEW JERSEY OMB CENTRALIZED PAYROLL
40 PITTSTOWN RD
CLINTON, NJ 088091209
9087301301
WARREN SKIN CARE CENTER PA
755 MEMORIAL PKWY
PHILLIPSBURG, NJ 088652773
9083871001
WARREN SKIN CARE CENTER PA
2209 LEHIGH ST
EASTON, PA 180423819
9083871001
Source: CMS National Downloadable File, September 2026.