Graduated: 1999
NPI: 1912941014
Practice Locations (3)
10201 66TH RD
FOREST HILLS, NY 113752029
7184339356
11203 QUEENS BLVD, SUITE 207
FOREST HILLS, NY 113755550
7184339356
8918 63RD DR
REGO PARK, NY 113743858
7184439356
Source: CMS National Downloadable File, September 2026.