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 | 225100000X | Physical Therapist | | 003778 | 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 | 0401995 | OTHER | NEW YORK | US FAMILY-ORTHONET TUCKAHOE |
| 2 | PT003778A-05 | OTHER | NEW YORK | HEALTH FIRST -GRP ID: 272438129-001 |
| 3 | ASC-616130500 | OTHER | NEW YORK | FECA/OFFICE OF WORKERS COMPENSATION PROGRAMS |
| 4 | 272438120 | OTHER | NEW YORK | HUDSON HEALTH PLAN-GROUP |
| 5 | 03282455 | MEDICAID | NEW YORK | |
| 6 | 0401997 | OTHER | NEW YORK | AETNA-ORTHONET MCLEAN |
| 7 | 0401997 | OTHER | NEW YORK | CIGNA-ORTHONET MCLEAN |
| 8 | 0401997 | OTHER | NEW YORK | US FAMILY-ORTHONET MCLEAN |
| 9 | 2343974 | OTHER | NEW YORK | HUMANA-GROUP |
| 10 | 272438120 | OTHER | NEW YORK | POMCO-GROUP |
| 11 | 123832P | OTHER | NEW YORK | EMBLEM HEALTH/GHI/HIP/PPO/POS/EPO |
| 12 | A400061623 | MEDICARE PIN | NEW YORK | |
| 13 | 0401995 | OTHER | NEW YORK | AETNA-ORTHONET TUCKAHOE |
| 14 | 0401995 | OTHER | NEW YORK | CIGNA-ORTHONET TUCKAHOE |
| 15 | 272438120 | OTHER | NEW YORK | FPN-GROUP |
| 16 | 01827690 | OTHER | NEW YORK | AMERIGROUP |
| 17 | 786980 | OTHER | NEW YORK | OPTUMN PHYSICAL THERAPY-GROUP |
| 18 | 4412422 | OTHER | NEW YORK | AETNA LOCAL SEUI 1199 |
