Graduated: 2013
NPI: 1689108185
Practice Locations (2)
OPTUM MEDICAL CARE OF NEW JERSEY PC
506 BROADWAY
BAYONNE, NJ 070023712
2014717012
CHOCTAW NATION OF OKLAHOMA
1201 W LIBERTY RD, CHOCTAW NATION HEALTH CARE ATOKA
ATOKA, OK 745251639
9185677000
Source: CMS National Downloadable File, September 2026.