Graduated: 1984
NPI: 1861554164
Practice Locations (3)
NORTH SHORE-LIJ MEDICAL PC
10201 66TH RD
FOREST HILLS, NY 113752029
7188304000
11302 107TH AVE
SOUTH RICHMOND HILL, NY 114192502
11302 107TH AVE
S RICHMOND HL, NY 114192502
7183232435
Source: CMS National Downloadable File, September 2026.