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 | 207V00000X | Obstetrics & Gynecology | | C1-0007396 | DELAWARE | No |
| 2 | 207VF0040X | Obstetrics & Gynecology | Urogynecology and Reconstructive Pelvic Surgery | C1-0007396 | DELAWARE | No |
| 3 | 207V00000X | Obstetrics & Gynecology | | MA077964 | NEW JERSEY | No |
| 4 | 207VF0040X | Obstetrics & Gynecology | Urogynecology and Reconstructive Pelvic Surgery | 25MA07796400 | NEW JERSEY | No |
| 5 | 207V00000X | Obstetrics & Gynecology | | 102645 | WISCONSIN | No |
| 6 | 2086S0122X | Surgery | Plastic and Reconstructive Surgery | MA077964 | NEW JERSEY | No |
| 7 | 2088F0040X | Urology | Urogynecology and Reconstructive Pelvic Surgery | C1-0007396 | DELAWARE | No |
| 8 | 2088F0040X | Urology | Urogynecology and Reconstructive Pelvic Surgery | 25MA07796400 | NEW JERSEY | No |
| 9 | 207VF0040X | Obstetrics & Gynecology | Urogynecology and Reconstructive Pelvic Surgery | 102645 | WISCONSIN | 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 | 60032176 | OTHER | NEW JERSEY | HORIZON NJ HEALTH |
| 2 | 0047147 | MEDICAID | NEW JERSEY | |
| 3 | 3687734 | OTHER | NEW JERSEY | AETNA |
| 4 | 3K6122 | OTHER | NEW JERSEY | HEALTHNET |
| 5 | 223235UGN | OTHER | DELAWARE | HORIZON BC BS OF DE |
| 6 | 8988499 | OTHER | NEW JERSEY | CIGNA |
| 7 | P3500220 | OTHER | NEW JERSEY | OXFORD |
| 8 | 1000036281 | MEDICAID | DELAWARE | |
| 9 | 1727563 | OTHER | DELAWARE | AMERIHEALTH/DELAWARE |
| 10 | 306494 | OTHER | DELAWARE | COVENTRY |
| 11 | 60022398 | OTHER | NEW JERSEY | HORIZON NJ HEALTH |
| 12 | 1000035674 | OTHER | DELAWARE | DELAWARE PHYSICIANS |
| 13 | 2395668000 | OTHER | NEW JERSEY | AMERIHEALTH/KEYSTONE/IBC |
| 14 | 26634 | OTHER | DELAWARE | CHRISTIANA HEALTH CARE |
| 15 | 2503150 | OTHER | NEW JERSEY | UNITED HEALTH CARE |
| 16 | 42302 | OTHER | NEW JERSEY | UNIVERISRY HEALTH PLAN |
