Medical school: STATE UNIVERSITY OF NEW YORK AT STONY BROOK, SCHOOL OF MEDICINE
Graduated: 1996
NPI: 1902965353
Practice Locations (2)
15905 92ND ST
HOWARD BEACH, NY 114143123
7188353636
120 E 79TH ST, OFC 1A
NEW YORK, NY 100750319
2128610400
Source: CMS National Downloadable File, September 2026.