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 | 207UN0901X | Nuclear Medicine | Nuclear Cardiology | 25MA07224100 | NEW JERSEY | No |
| 2 | 207RC0000X | Internal Medicine | Cardiovascular Disease | 25MA07224100 | 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 | P2523822 | OTHER | | OXFORD HEALTH PLANS |
| 2 | 2080707000 | OTHER | PENNSYLVANIA | KEYSTONE HEALTH PLAN |
| 3 | 046929BDF | MEDICARE PIN | NEW JERSEY | |
| 4 | 223258770 | OTHER | | DEVON |
| 5 | 8561605 | MEDICAID | NEW JERSEY | |
| 6 | 2607048 | OTHER | | AETNA US HEALTHCARE |
| 7 | H34350 | MEDICARE UPIN | | |
| 8 | 1391578 | OTHER | | AMERIHEALTH ADMIN PPO |
| 9 | 1391578 | OTHER | PENNSYLVANIA | BLUE SHIELD PA |
| 10 | 223258770 | OTHER | | GHI |
| 11 | 223258770 | OTHER | NEW JERSEY | HORZON BCBS OF NJ |
| 12 | 223258770 | OTHER | | UNITED HEALTH CARE |
| 13 | 060063735 | OTHER | | RAILROAD MEDICARE |
| 14 | 223258770 | OTHER | | MAGNA CARE |
| 15 | 232258770 | OTHER | | CIGNA |
| 16 | 2080707000 | OTHER | | AMERIHEALTH HMO |
| 17 | 2K2546 | OTHER | | HEALTHNET |
| 18 | 223258770 | OTHER | | AARP HEALTH INSURANCE |
| 19 | 223258770 | OTHER | | BEECHSTREET |
| 20 | 223258770 | OTHER | | GREAT WEST |