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 | 2085R0001X | Radiology | Radiation Oncology | MD06662 | RHODE ISLAND | 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 | AA507747 | OTHER | RHODE ISLAND | HUMANA SNERC |
| 2 | AA507747 | OTHER | RHODE ISLAND | HARVARD PILGRIM |
| 3 | U400322033 SCRT | MEDICARE PIN | RHODE ISLAND | |
| 4 | AA507739 | OTHER | RHODE ISLAND | HARVARD PILGRIM |
| 5 | U400322039 SNERC | MEDICARE PIN | RHODE ISLAND | |
| 6 | P01703483 | OTHER | RHODE ISLAND | RR MEDICARE SNERC |
| 7 | P01703481 | OTHER | RHODE ISLAND | RR MEDICARE RWRT |
| 8 | 764228 | OTHER | RHODE ISLAND | TUFTS |
| 9 | P01728458 - SCRT | OTHER | RHODE ISLAND | RR MEDICARE |
| 10 | E97887 | MEDICARE UPIN | TENNESSEE | |
| 11 | AA507739 | OTHER | RHODE ISLAND | HUMANA SCRT |
| 12 | AA507740 | OTHER | RHODE ISLAND | HARVARD PILGRIM |
| 13 | 008067185 | MEDICAID | CONNECTICUT | |
| 14 | AA507740 | OTHER | RHODE ISLAND | HUMANA RWRT |
| 15 | U400322037 RWRT | MEDICARE PIN | RHODE ISLAND | |
| 16 | 0219505 | OTHER | RHODE ISLAND | CIGNA |
