Graduated: 1997
NPI: 1982703997
Practice Locations (2)
NORTH SHORE-LIJ MEDICAL PC
7559 263RD ST, RM 132
GLEN OAKS, NY 110041150
7184708023
200 S SERVICE RD, SUITE 101
ROSLYN HEIGHTS, NY 115772133
5162973057
Source: CMS National Downloadable File, September 2026.