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 | 111N00000X | Chiropractor | | X006933 | 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 | 1C9303 | OTHER | NEW YORK | HEALTHNET ID# |
| 2 | 5303872 | OTHER | NEW YORK | GHI / ALIGNIS ID# |
| 3 | 0002357 | OTHER | NEW YORK | SELECT PRO ID# |
| 4 | P62591639 | OTHER | NEW YORK | MULTIPLAN ID# |
| 5 | 1295243 | OTHER | NEW YORK | UNITED HEALTHCARE ID# |
| 6 | 5597187 | OTHER | NEW YORK | AETNA ID # |
| 7 | 63503 | OTHER | NEW YORK | VYTRA ID# |
| 8 | P744425 | OTHER | NEW YORK | OXFORD ID # |
| 9 | NY06933 | OTHER | NEW YORK | LANDMARK HC ID# |
| 10 | U23279 | MEDICARE UPIN | NEW YORK | |
| 11 | 322612 | OTHER | NEW YORK | ACN GROUP ID# |
| 12 | X4967-1 | MEDICARE ID-TYPE UNSPECIFIED | NEW YORK | EMPIRE MEDICARE NUMBER |
| 13 | CO6933-8 | OTHER | NEW YORK | NYS WORK COMP # |
