Graduated: 1982
NPI: 1841288487
Practice Locations (3)
100 SULLIVAN ST, APT 4A
New York, NY 100123625
100 SULLIVAN ST, APT 4A
NEW YORK, NY 100123625
230 W 13TH ST, FL 3
NEW YORK, NY 100117700
2129660958
Source: CMS National Downloadable File, September 2026.