Graduated: 2016
NPI: 1760831747
Practice Locations (4)
171 GRANDVIEW AVE, SUITE 201
WATERBURY, CT 067082522
2211 CONGRESS ST
PORTLAND, ME 041021941
185 COLUMBIA HTS, APT 1
BROOKLYN, NY 112012136
425 N 21ST ST, SUITE 301
CAMP HILL, PA 170112223
Source: CMS National Downloadable File, September 2026.