Graduated: 1992
NPI: 1912157116
Practice Locations (4)
1269 KENNEDY BLVD
BAYONNE, NJ 070022285
2016005119
1269 KENNEDY BLVD, 1ST
BAYONNE, NJ 070024654
135 VANDERBILT AVE
STATEN ISLAND, NY 103042604
7184470701
275 CASTLETON AVE
STATEN ISLAND, NY 103012709
7184470701
Source: CMS National Downloadable File, September 2026.