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 | 103TC0700X | Psychologist | Clinical | | | No |
| 2 | 104100000X | Social Worker | | | | No |
| 3 | 207Q00000X | Family Medicine | | | | No |
| 4 | 207RC0000X | Internal Medicine | Cardiovascular Disease | | | No |
| 5 | 207RC0001X | Internal Medicine | Clinical Cardiac Electrophysiology | | | No |
| 6 | 207RE0101X | Internal Medicine | Endocrinology, Diabetes & Metabolism | | | No |
| 7 | 207RG0100X | Internal Medicine | Gastroenterology | | | No |
| 8 | 207RH0003X | Internal Medicine | Hematology & Oncology | | | No |
| 9 | 207V00000X | Obstetrics & Gynecology | | | | No |
| 10 | 207Y00000X | Otolaryngology | | | | No |
| 11 | 207YS0123X | Otolaryngology | Facial Plastic Surgery | | | No |
| 12 | 2084P0800X | Psychiatry & Neurology | Psychiatry | | | No |
| 13 | 2085R0001X | Radiology | Radiation Oncology | | | No |
| 14 | 208600000X | Surgery | | | | No |
| 15 | 207R00000X | Internal Medicine | | | | Yes |