Medical school: STATE UNIVERSITY OF NY UPSTATE MEDICAL UNIVERSITY
Graduated: 1987
NPI: 1851319685
Practice Locations (2)
GREAT LAKES PHYSICIAN PRACTICE PC
15 S MAIN ST
JAMESTOWN, NY 147016627
GREAT LAKES PHYSICIAN PRACTICE PC
31 SHERMAN ST, SUITE 2400
JAMESTOWN, NY 147017082
8144835306
Source: CMS National Downloadable File, September 2026.