Medical school: UNIVERSITY OF CINCINNATI COLLEGE OF MEDICINE
Graduated: 1990
NPI: 1750339008
Practice Locations (2)
SOUTHSIDE FACULTY MEDICAL AFFILIATES UNIVERSITY FACULTY PRACTICE CORP
9525 QUEENS BLVD
REGO PARK, NY 113744510
7183605522
NORTH SHORE-LIJ MEDICAL PC
900 FRANKLIN AVE
VALLEY STREAM, NY 115802145
5162566000
Source: CMS National Downloadable File, September 2026.