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 | 2085D0003X | Radiology | Diagnostic Neuroimaging | MD05993 | RHODE ISLAND | No |
| 2 | 2085B0100X | Radiology | Body Imaging | MD05993 | RHODE ISLAND | No |
| 3 | 2085N0700X | Radiology | Neuroradiology | MD05993 | RHODE ISLAND | No |
| 4 | 2085N0904X | Radiology | Nuclear Radiology | MD05993 | RHODE ISLAND | No |
| 5 | 2085R0204X | Radiology | Vascular & Interventional Radiology | MD05993 | RHODE ISLAND | No |
| 6 | 2085U0001X | Radiology | Diagnostic Ultrasound | MD05993 | RHODE ISLAND | No |
| 7 | 2085R0202X | Radiology | Diagnostic Radiology | MD05993 | RHODE ISLAND | 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 | 2203 | OTHER | RHODE ISLAND | NEIGHBORHOOD HLTH PLAN |
| 2 | 300067258 | OTHER | RHODE ISLAND | RAILROAD MEDICARE |
| 3 | 7000271 | MEDICAID | RHODE ISLAND | |
| 4 | 16-00137 | OTHER | RHODE ISLAND | UNITED HEALTHCARE |
| 5 | 4747918 | OTHER | RHODE ISLAND | CIGNA |
| 6 | 50356624 | OTHER | RHODE ISLAND | UNICARE LIFE & HEALTH INS |
| 7 | AA42213 | OTHER | RHODE ISLAND | HARVARD PILGRIM HEALTH |
| 8 | 007000330 | MEDICARE OSCAR/CERTIFICATION | RHODE ISLAND | |
| 9 | 1198-5 | OTHER | RHODE ISLAND | BCBS OFFICE PROVIDER NO |
| 10 | 5055327 | OTHER | RHODE ISLAND | AETNA |
| 11 | 000361 | OTHER | RHODE ISLAND | BLUE CHIP |
| 12 | 005993 | OTHER | RHODE ISLAND | TUFTS HEALTH PLAN |
| 13 | 1570-5 | OTHER | RHODE ISLAND | BCBS KENT PROVIDER NO |
| 14 | A58292 | MEDICARE UPIN | RHODE ISLAND | |
| 15 | 007000271 | MEDICARE PIN | RHODE ISLAND | |