Graduated: 2009
NPI: 1669601811
Practice Locations (2)
NORTHEAST MEDICAL GROUP INC
50 GAYLORD FARM RD
WALLINGFORD, CT 064922828
2036793553
PROSPECT CT MEDICAL FOUNDATION INC
64 ROBBINS ST
WATERBURY, CT 067082613
2035736263
Source: CMS National Downloadable File, September 2026.