Graduated: 2012
NPI: 1851654149
Practice Locations (2)
NORTH SHORE-LIJ MEDICAL PC
450 LAKEVILLE RD
NEW HYDE PARK, NY 110421118
5167348500
SOUTHSIDE FACULTY MEDICAL AFFILIATES UNIVERSITY FACULTY PRACTICE CORP
9525 QUEENS BLVD
REGO PARK, NY 113744510
7183605522
Source: CMS National Downloadable File, September 2026.