Graduated: 2013
NPI: 1982309175
Practice Locations (3)
10652 WRIGLEY FIELD AVE
Denham Springs, LA 707261840
123 HIGHLAND AVE, SUITE 201
GLEN RIDGE, NJ 070281573
MONTAINSIDE MEDICAL CTR, 1 BAY AVENUE/ DEPT OF MEDICINE
MONTCLAIR, NJ 07042
Source: CMS National Downloadable File, September 2026.