Medical school: STATE UNIVERSITY OF NEW YORK AT STONY BROOK, SCHOOL OF MEDICINE
Graduated: 1993
NPI: 1902980139
Practice Locations (1)
REVERE MEDICAL ASSOCIATES PC
535 PORT WASHINGTON BLVD, SUITE 201
PORT WASHINGTON, NY 110504227
5169449515
Source: CMS National Downloadable File, September 2026.