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 | 207L00000X | Anesthesiology | | MD045589L | PENNSYLVANIA | 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 | 23-2919275 | OTHER | PENNSYLVANIA | PROCURA MANAGEMENT |
| 2 | 050068192 | OTHER | PENNSYLVANIA | RAIL ROAD MEDICARE |
| 3 | 22-1994560 | OTHER | PENNSYLVANIA | QUALCARE |
| 4 | 22-1994560 | OTHER | NEW JERSEY | HORIZON BLUE CROSS BLUE SHIELD |
| 5 | 23-2919275 | OTHER | NEW JERSEY | HORIZON BLUE CROSS BLUE SHIELD |
| 6 | 23-2919275 | OTHER | PENNSYLVANIA | UNITED HEALTHCARE/OXFORD |
| 7 | 23-2919275 | OTHER | PENNSYLVANIA | QUALCARE |
| 8 | 50059326 | OTHER | PENNSYLVANIA | CAPITAL BLUE CROSS |
| 9 | 020429 | OTHER | PENNSYLVANIA | PERSONAL CHOICE |
| 10 | 23-2919275 | OTHER | PENNSYLVANIA | FIRST MCO |
| 11 | 23-2919275 | OTHER | PENNSYLVANIA | GREAT WEST HEALTHCARE |
| 12 | 23-2919275 | OTHER | PENNSYLVANIA | HEALTH AMERICA/HEALTH ASSURANCE |
| 13 | 23-2919275 | OTHER | NEW JERSEY | FIRST MCO |
| 14 | 2551744 | OTHER | PENNSYLVANIA | AETNA |
| 15 | 888068 | OTHER | PENNSYLVANIA | FIRST HEALTH NETWORK |
| 16 | 020429 | OTHER | PENNSYLVANIA | HIGHMARK BLUE SHIELD |
| 17 | 22-1994560 | OTHER | PENNSYLVANIA | DEVON |
| 18 | 22-1994560 | OTHER | PENNSYLVANIA | FIRST MCO |
| 19 | 22-1994560 | OTHER | NEW JERSEY | UNITED HEALTHCARE/OXFORD |
| 20 | 22-1994560 | OTHER | NEW JERSEY | FIRST MCO |
| 21 | 22-1994560 | OTHER | PENNSYLVANIA | UNITED HEALTHCARE/OXFORD |
| 22 | 0658614000 | OTHER | PENNSYLVANIA | IBC PRODUCTS |
| 23 | 23-2919275 | OTHER | PENNSYLVANIA | DEVON |
| 24 | 50058029 | OTHER | PENNSYLVANIA | CAPITAL BLUE CROSS |
| 25 | 22-1994560 | OTHER | PENNSYLVANIA | PROCURA MANAGEMENT |
| 26 | 22-1994560 | OTHER | PENNSYLVANIA | HEALTH AMERICA/HEALTH ASSURANCE |
| 27 | P00475880 | OTHER | PENNSYLVANIA | RAILROAD MEDICARE (GROUP DB0435) |
| 28 | 23-2919275 | OTHER | NEW JERSEY | UNITED HEALTHCARE/OXFORD |
| 29 | DD1386 | OTHER | PENNSYLVANIA | RAILROAD (GROUP) |
| 30 | 1296652 | OTHER | PENNSYLVANIA | CIGNA |
| 31 | 22-1994560 | OTHER | PENNSYLVANIA | GREAT WEST HEALTHCARE |
| 32 | 3799603 | OTHER | PENNSYLVANIA | AETNA |