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 | 207RH0003X | Internal Medicine | Hematology & Oncology | 25MA04569800 | NEW JERSEY | 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 | 110027221 | OTHER | | RAILROAD MEDICARE |
| 2 | ========= | OTHER | NEW JERSEY | CIGNA |
| 3 | 0004104162 | OTHER | | AETNA LIFE INSURANCE |
| 4 | 228906200 | OTHER | NEW JERSEY | AMERIHEALTH HMO/PPO/POS |
| 5 | 84254 | OTHER | NEW JERSEY | AMERICAID |
| 6 | 000563232 | OTHER | | HIGHMARK |
| 7 | 073854 | MEDICARE PIN | NEW JERSEY | |
| 8 | 000563232 | OTHER | NEW JERSEY | AMERIHEALTH |
| 9 | 0057805 | OTHER | NEW JERSEY | AETNA |
| 10 | 7437560 | OTHER | | MAMSI |
| 11 | 0013749 | MEDICAID | NEW JERSEY | |
| 12 | Q11701 | OTHER | NEW JERSEY | AMERIHEALTH ADMINISTRATOR |
| 13 | P515578 | OTHER | NEW JERSEY | OXFORD |
| 14 | 0527530001 | OTHER | NEW JERSEY | MEDICARE DMERC |
| 15 | 1730136854 | OTHER | NEW JERSEY | RAILROAD MEDICARE FROUP MEMBER NPI |
| 16 | DN2359 | OTHER | NEW JERSEY | RAILROAD MEDICARE GROUP PTAN |
| 17 | E23757 | MEDICARE UPIN | NEW JERSEY | |
| 18 | E63232 | OTHER | NEW JERSEY | AMERIHEALTH ADMINISTRATOR |
| 19 | 001611701 | OTHER | NEW JERSEY | AMERIHEALTH |
| 20 | ========= | OTHER | NEW JERSEY | HORIZON |
