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 | 204C00000X | Neuromusculoskeletal Medicine, Sports Medicine | | 233661-1 | NEW YORK | No |
| 2 | 204D00000X | Neuromusculoskeletal Medicine & OMM | | 233661-1 | NEW YORK | No |
| 3 | 2080S0010X | Pediatrics | Sports Medicine | 233661-1 | NEW YORK | No |
| 4 | 208100000X | Physical Medicine & Rehabilitation | | 233661-1 | NEW YORK | No |
| 5 | 2081P0004X | Physical Medicine & Rehabilitation | Spinal Cord Injury Medicine | 233661-1 | NEW YORK | No |
| 6 | 2081P0010X | Physical Medicine & Rehabilitation | Pediatric Rehabilitation Medicine | 233661-1 | NEW YORK | No |
| 7 | 2081P2900X | Physical Medicine & Rehabilitation | Pain Medicine | 233661-1 | NEW YORK | No |
| 8 | 2081S0010X | Physical Medicine & Rehabilitation | Sports Medicine | 233661-1 | NEW YORK | No |
| 9 | 208VP0000X | Pain Medicine | Pain Medicine | 233661-1 | NEW YORK | No |
| 10 | 208VP0014X | Pain Medicine | Interventional Pain Medicine | 233661-1 | NEW YORK | Yes |
| 11 | 209800000X | Legal Medicine | | 233661-1 | NEW YORK | No |
| 12 | 2085B0100X | Radiology | Body Imaging | 25MA07825600 | NEW JERSEY | No |
| 13 | 2085D0003X | Radiology | Diagnostic Neuroimaging | 25MA07825600 | NEW JERSEY | No |
| 14 | 2085R0202X | Radiology | Diagnostic Radiology | 25MA07825600 | NEW JERSEY | No |
| 15 | 2085U0001X | Radiology | Diagnostic Ultrasound | 25MA07825600 | NEW JERSEY | No |