Graduated: 2019
NPI: 1679331003
Practice Locations (2)
FPA HOSPITAL BASED
1 GUSTAVE L LEVY PL
NEW YORK, NY 100296504
2122416426
NORTH SHORE MEDICAL GROUP OF THE MOUNT SINAI SCHOOL OF MEDICINE
2020 WANTAGH AVE, MOUNT SINAI DOCTORS WANTAGH
WANTAGH, NY 117933931
5169614545
Source: CMS National Downloadable File, September 2026.