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 | 2085R0001X | Radiology | Radiation Oncology | 188109 | 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 | 10039815 | OTHER | NEW YORK | CDPHP |
2 | 300026726 | MEDICARE UPIN | NEW YORK | |
3 | 920002535 | MEDICARE ID-TYPE UNSPECIFIED | NEW YORK | RAILROAD MEDICARE |
4 | E24302 | MEDICARE UPIN | NEW YORK | |
5 | P672354 | OTHER | NEW YORK | OXFORD LIBERTY |
6 | 397004 | OTHER | NEW YORK | MVP |
7 | P673936 | OTHER | NEW YORK | OXFORD FREEDOM |
8 | 930721 | OTHER | NEW YORK | EMPIRE BCBS |
9 | 7299684 | OTHER | NEW YORK | GHI PPO |
10 | 4000061 | OTHER | NEW YORK | GHI |
11 | 000470812002 | OTHER | NEW YORK | BCBS NE NY |
12 | 2330133 | OTHER | NEW YORK | AETNA USHC HMO |
13 | 30K0610 | MEDICARE ID-TYPE UNSPECIFIED | NEW YORK | |
14 | 01348118 | MEDICAID | NEW YORK | |
15 | 10642 | OTHER | NEW YORK | GHI HMO |
16 | 30K061 | OTHER | NEW YORK | EMPIRE BCBS |
17 | 397115 | OTHER | NEW YORK | MVP |
18 | 000470812001 | OTHER | NEW YORK | BCBS NE NY |
19 | 4112605 | OTHER | NEW YORK | AETNA USHC PPO |
20 | 2330132 | OTHER | NEW YORK | AETNA USHC HMO |