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 | 213E00000X | Podiatrist | | 002464 | 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 | 480033899 | OTHER | NEW YORK | MEDICAIRE RAILROAD |
| 2 | 47808P | OTHER | NEW YORK | HIP |
| 3 | AA1073 | OTHER | NEW YORK | EMPIRE BC/BS |
| 4 | YS094 | OTHER | NEW YORK | OXFORD |
| 5 | 220-148 | OTHER | NEW YORK | WORKMANS COMP. |
| 6 | 0076764 | OTHER | NEW YORK | GHI |
| 7 | 2C6600 | OTHER | NEW YORK | HEALTHNET HEALTH PLAN |
| 8 | 480020684 | OTHER | NEW YORK | MEDICAIRE RAILROAD |
| 9 | P27582 | MEDICARE PIN | NEW YORK | |
| 10 | P27582 | OTHER | NEW YORK | EMPIRE BC/BS |
| 11 | P27581 | OTHER | NEW YORK | EMPIRE BC/BS |
| 12 | 4369401 | OTHER | NEW YORK | AETNA HEALTH PLANS |
| 13 | 10053408 | OTHER | NEW YORK | CDHP |
| 14 | 00418075 | MEDICAID | NEW YORK | |
| 15 | AA1073 | MEDICARE PIN | NEW YORK | |
| 16 | 3885290001 | MEDICARE NSC | NEW YORK | |
| 17 | P27581 | MEDICARE PIN | NEW YORK | |
