Facts
- Status
- A
- Credential
- MD
- Type
- Individual
- Enumeration date
- 2006-03-30
- Last updated
- 2026-07-13
Specialties
Licenses
- License NY
- 113487
Location
- Practice location
- 159 JEFFERSON HTS, SUITE 303
- City
- CATSKILL NY
- Postal code
- 124141237
- Phone
- 518-943-4046
Medicare
- PECOS
- No PECOS enrollment row matched this NPI.
LEIE
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Nearby
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Removal request
Public data from NPPES and CMS. Not a credentialing determination.