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 | 207W00000X | Ophthalmology | | MA36318 | NEW JERSEY | 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 | 9537062 | OTHER | NEW YORK | GHI |
| 2 | 0K0704 | OTHER | | HEALTH NET OF THE NORTHEA |
| 3 | 13254 | OTHER | NEW JERSEY | OPERATING ENGINEERS OF LO |
| 4 | S46801 | OTHER | ILLINOIS | AMERICAN IMAGING MGMT |
| 5 | 222302679 | OTHER | | GEHA |
| 6 | 895564 | OTHER | PENNSYLVANIA | AMERIHEALTH PPO |
| 7 | 010036318NJ01 | OTHER | NEW YORK | ANTHEM HEALTH |
| 8 | 0076931000 | OTHER | NEW JERSEY | AMERIHEALTH HMO POS |
| 9 | IS269 | OTHER | | OXFORD |
| 10 | 0951265 | OTHER | | CIGNA HEALTHCARE |
| 11 | 9537062 | OTHER | NEW YORK | MULTIPLAN |
| 12 | 1323553 | OTHER | | IL AZ FIRST HEALTH |
| 13 | 53A861 | OTHER | NEW YORK | WELL CHOICE |
| 14 | C52985 | MEDICARE UPIN | | |
| 15 | 1323553 | OTHER | | MAIL HANDLERS BENEFIT PLA |
| 16 | 447459 | OTHER | | UNITED HEALTHCARE |
| 17 | 077626 | MEDICARE ID-TYPE UNSPECIFIED | | EMPIRE MEDICARE |
| 18 | 0839480001 | MEDICARE NSC | NEW JERSEY | |
| 19 | 0038164 | OTHER | | AETNA |
| 20 | 052811440 | OTHER | | RR MEDICARE |
