Graduated: 2025
NPI: 1801680327
Practice Locations (4)
2510 30TH AVE
ASTORIA, NY 111022418
150 E 42ND STREET 9TH FLOOR, DESK 9.A.30.6
New York, NY 100175639
150 E 42ND ST 9TH FLOOR
NEW YORK, NY 100175639
215 E 124TH ST, APT 11L
NEW YORK, NY 100352143
Source: CMS National Downloadable File, September 2026.