Graduated: 1991
NPI: 1992771562
Practice Locations (2)
NORTHEAST MEDICAL GROUP INC
23 CLARA DR
MYSTIC, CT 063551959
8605725782
WOOD RIVER HEALTH SERVICES INC
823 MAIN ST
HOPE VALLEY, RI 028321920
4015392461288
Source: CMS National Downloadable File, September 2026.