Taxonomy Codes
The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:
| No. |
Taxonomy Code |
Taxonomy Clasification |
Taxonomy Specialization |
License Number |
License State |
Primary |
| 1 | 207R00000X | Internal Medicine | | 121327 | NEW YORK | Yes |
Other Identifiers
The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.
| No. |
Other Provider Identifier |
Other Provider Identifier Type |
Other Provider Identifier State |
Other Provider Identifier Issuer |
| 1 | 141659448 | OTHER | | UNITED HEALTH CARE ALBANY |
| 2 | 141752151 | OTHER | | STATEWIDE PPO ROTTERDAM |
| 3 | 000400079001 | OTHER | | URGENT CARE |
| 4 | 11545 | OTHER | | MVP ALBANY |
| 5 | 141659448 | OTHER | | UNITED HEALTH CARE LATHAM |
| 6 | 141659448 | OTHER | | STATEWIDE PPO LATHAM |
| 7 | 23S302 | OTHER | | BLUE CROSS BLUE SHIELD AL |
| 8 | B15757 | MEDICARE UPIN | | |
| 9 | 55505 | OTHER | | GHI HMO ALBANY |
| 10 | 000496767002 | OTHER | | BLUE SHIELD OF NENY LA |
| 11 | 01598 | OTHER | | MVP LATHAM |
| 12 | 23S301 | OTHER | | BLUE CROSS BLUE SHIELD LA |
| 13 | 23S303 | OTHER | | BLUE CROSS BLUE SHIELD RO |
| 14 | 55505 | OTHER | | GHI HMO LATHAM |
| 15 | 2594606 | OTHER | | GHI LATHAM |
| 16 | 4295947 | OTHER | | AETNA |
| 17 | 2594606 | OTHER | | GHI ALBANY |
| 18 | 000496767001 | OTHER | | BLUE SHIELD OF NENY AL |
| 19 | 10010858 | OTHER | | CDPHP ALBANY |
| 20 | 141659448 | OTHER | | STATEWIDE PPO ALBANY |
