Graduated: 2015
NPI: 1669021465
Practice Locations (4)
255 CHESTNUT ST
LAKEWOOD, NJ 087015808
165 DIVISION AVE
BROOKLYN, NY 112117105
8931 161ST ST
JAMAICA, NY 114326140
6827 76TH ST
MIDDLE VILLAGE, NY 113792826
Source: CMS National Downloadable File, September 2026.