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 | 213E00000X | Podiatrist | | N005081 | 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 | 37093P | OTHER | NEW YORK | HIP ID NUMBER |
| 2 | 10079642 | OTHER | NEW YORK | CDPHP ID NUMBER |
| 3 | P000000035429 | OTHER | NEW YORK | GHI HMO ID NUMBER |
| 4 | U43855 | MEDICARE UPIN | NEW YORK | |
| 5 | 480034149 | OTHER | NEW YORK | MEDICARE RAILRD. ID NUMBE |
| 6 | 6200868 | OTHER | NEW YORK | GHI ID NUMBER |
| 7 | 01461852 | MEDICAID | NEW YORK | |
| 8 | PG3761 | OTHER | NEW YORK | BCBS ID NUMBER |
| 9 | PG3761 | MEDICARE PIN | NEW YORK | |
| 10 | 004213 | OTHER | NEW YORK | COMMUNITY CHOICE ID# |
| 11 | 4890270001 | OTHER | NEW YORK | MEDCARE DMERC ID NUMBER |
| 12 | P489041 | OTHER | NEW YORK | OXFORD ID NUMBER |
| 13 | 3C8908 | OTHER | NEW YORK | HEALTHNET ID NUMBER |
| 14 | 960784 | OTHER | NEW YORK | MVP ID NUMBER |