Medical school: UNIVERSITY OF ILLINOIS COLLEGE OF MED (CHI/PEOR/ROCK/CHM-URB)
Graduated: 1987
NPI: 1770696536
Practice Locations (1)
UPSTATE COMMUNITY MEDICAL, PC
4900 BROAD RD
SYRACUSE, NY 132152265
3154925678
Source: CMS National Downloadable File, September 2026.