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 | 207P00000X | Emergency Medicine | | 133867 | 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 | 77599226 | OTHER | | AETNA PPO PROVIDER ID# |
| 2 | F50947 | MEDICARE UPIN | | |
| 3 | 38H432 | MEDICARE PIN | NEW YORK | |
| 4 | 0511100000034 | OTHER | | FIDELISCARE PROVIDER ID# |
| 5 | 4147732 | OTHER | | MVP HEALTHPLAN ID # |
| 6 | 2H7971 | OTHER | | EMPIRE BCBS PROVIDER PIN# |
| 7 | 5C7511 | OTHER | | HEALTHNET PROVIDER ID# |
| 8 | 10112151-D815 | OTHER | | CDPHP PROV & GRP PIN |
| 9 | 2665341 | OTHER | | AETNA HMO PROVIDER ID# |
| 10 | 000000093405 | OTHER | | GHI HMO PROVIDER ID# |
| 11 | 38H4373781 | MEDICARE PIN | NEW YORK | |
| 12 | P1974829 | OTHER | | OXFORD HEALTHPLAN ID # |
| 13 | 4702133 | OTHER | | GHI PPO PROVIDER ID |
