Graduated: 2010
NPI: 1659673986
Practice Locations (4)
PO BOX
ATLANTA, GA 30374
PO BOX, SUITE 746087
ATLANTA, GA 303746087
445 PARK AVE
BROOKLYN, NY 112052735
3636 33RD ST, SUITE 306
LONG ISLAND CITY, NY 111062329
Source: CMS National Downloadable File, September 2026.