Graduated: 2022
NPI: 1851887517
Practice Locations (2)
NORTH SHORE-LIJ MEDICAL PC
10201 66TH RD
FOREST HILLS, NY 113752029
7188304000
JOHN T MATHER MEMORIAL HOSPITAL
75 N COUNTRY RD
PORT JEFFERSON, NY 117772119
6314731320
Source: CMS National Downloadable File, September 2026.