Graduated: 1988
NPI: 1922057967
Practice Locations (4)
NORTH SHORE-LIJ MEDICAL PC
2110 S 64TH AVE, APT 312
OMAHA, NE 681062834
5164057080
SOUTHSIDE FACULTY MEDICAL AFFILIATES UNIVERSITY FACULTY PRACTICE CORP
2110 S 64TH AVE, APT 312
OMAHA, NE 681062834
5164057000
NORTH SHORE-LIJ MEDICAL PC
10201 66TH RD
FOREST HILLS, NY 113752029
7188304000
SOUTHSIDE FACULTY MEDICAL AFFILIATES UNIVERSITY FACULTY PRACTICE CORP
1220 HICKSVILLE RD
SEAFORD, NY 117831604
5162663456
Source: CMS National Downloadable File, September 2026.