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 | 207V00000X | Obstetrics & Gynecology | | 1624361 | 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 | 2C4141 | OTHER | | HEALTHNET FORMERLY PHS |
| 2 | 672521 | OTHER | | EMPIRE PLAN UNITED HLTHCA |
| 3 | 67D411 | OTHER | | BLUE CHOICE HMP POS PPO |
| 4 | SF0000406 | OTHER | | FIRST HEALTH HLTH CARE CO |
| 5 | SF0000406 | OTHER | | AFFORDABLE NETWORKS |
| 6 | 49801 | OTHER | | NO CIGNA HMP POS PPO |
| 7 | 13254 | OTHER | | NYTRA NO SMART CHOICE |
| 8 | AF01086 | OTHER | | MDNY NO FOCUS |
| 9 | 672521 | MEDICARE ID-TYPE UNSPECIFIED | NEW YORK | |
| 10 | 2263840 | OTHER | | AETNA US HEALTHCARE |
| 11 | 4199010 | OTHER | | AETNA PPO MANAGED CHOICE |
| 12 | CP684 | OTHER | | OXFORD LIBERTY PLAN |
| 13 | 67D4111 | OTHER | | BLUE CROSS FEDERAL EMPLOY |
| 14 | 67D411 | OTHER | | NO BLUE CHOICE SR PLAN |
| 15 | CP684 | OTHER | | OXFORD HLTH PLNS & ADVTGE |
| 16 | 00961679 | MEDICAID | NEW YORK | |
| 17 | SF0000406 | OTHER | | SELECT PRO |
| 18 | 67Z521 | MEDICARE ID-TYPE UNSPECIFIED | | |
| 19 | B78921 | MEDICARE UPIN | | |
