Graduated: 2000
NPI: 1720268048
Practice Locations (2)
STATE OF CONNECTICUT
1635 CENTRAL AVE
BRIDGEPORT, CT 066102717
2035517464
STATE OF CONNECTICUT
78 TRIANGLE ST, BLDG 14
DANBURY, CT 068106977
2034483200
Source: CMS National Downloadable File, September 2026.