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 | 332B00000X | Durable Medical Equipment & Medical Supplies | | MA-7335 | MASSACHUSETTS | No |
| 2 | 332B00000X | Durable Medical Equipment & Medical Supplies | | | | No |
| 3 | 335G00000X | Medical Foods Supplier | | MA-7335 | MASSACHUSETTS | 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 | 000000022076 | OTHER | MASSACHUSETTS | BMC HEALTH NET |
| 2 | 00588237002 | OTHER | NEW YORK | BCBS OF WESTERN NY |
| 3 | 8290130 | OTHER | | MEDICA |
| 4 | 95Z042019MA01 | OTHER | | ANTHEM BCBS |
| 5 | 694981 | OTHER | MASSACHUSETTS | TUFTS |
| 6 | 70020000ZAR052 | OTHER | MASSACHUSETTS | BCBS |
| 7 | 704879 | OTHER | MASSACHUSETTS | HARVARD PILGRIM |
| 8 | 84199 | OTHER | | HEALTH PARTNERS |
| 9 | A2559180 | OTHER | | OXFORD HEALTH PLANS |
| 10 | 919669200 | OTHER | MINNESOTA | MN HEALTHCARE PROGRAMS |
| 11 | 10052249 | OTHER | | CDPHP |
| 12 | 36844 | OTHER | | MVP HEALTHCARE |
| 13 | MB0033 | OTHER | NEW JERSEY | HEALTH NET OF NJ |
| 14 | 2538703 | OTHER | | AETNA |
| 15 | 103968 | OTHER | MINNESOTA | UCARE OF MN |
| 16 | 91001158700 | OTHER | NEW JERSEY | AMERICHOICE OF NJ |
