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 | | 55237 | MASSACHUSETTS | 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 | 27410 | OTHER | | CHILDREN'S MEDICAL SECURI |
| 2 | J07034 | OTHER | | BLUE SHIELD INDEMNITY |
| 3 | J07034 | OTHER | | BS-BLUE CARE ELECT |
| 4 | 180009329 | OTHER | | RAILROAD MEDICARE |
| 5 | 055237 | OTHER | | TUFTS SECURE HORIZONS |
| 6 | 3031535 | OTHER | | MASS HEALTH (DIV MED SVCS |
| 7 | 7538944 | OTHER | | CIGNA HEALTH CARE |
| 8 | 7538944 | OTHER | | HEALTHSOURSCE MASSACHUSET |
| 9 | 055237 | OTHER | | TUFTS BENEFIT ADMINISTRAT |
| 10 | J07034 | OTHER | | HMO BLUE/BLUE CHOICE |
| 11 | 15986 | OTHER | | HARVARD PILGRIM POS PPO |
| 12 | B77257 | OTHER | | FIRST SENIORITY |
| 13 | 055237 | OTHER | | TUFTS |
| 14 | 055237 | OTHER | | TUFTS TOTAL HEALTH PLAN |
| 15 | 08-00480 | OTHER | | UNITED HEALTHCARE(HMO&PPO |
| 16 | 000600 | OTHER | | NEIGHBORHOOD HEALTH PLAN |
| 17 | 055237 | OTHER | | TUFTS COMMONWEALTH PPO |
| 18 | J07034 | OTHER | | BS-BLUE CARE 65 |
| 19 | B77257 | MEDICARE UPIN | | |
| 20 | J07034 | MEDICARE ID-TYPE UNSPECIFIED | | |
