Graduated: 2013
NPI: 1831527795
Practice Locations (3)
100 1ST ST, SUITE 301
HACKENSACK, NJ 076012190
30 PROSPECT AVE
HACKENSACK, NJ 076011914
30 PROSPECT AVE, FACULTY PRACTICE TRAILERS
HACKENSACK, NJ 076011914
Source: CMS National Downloadable File, September 2026.