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 | 174400000X | Specialist | | 179543 | NEW YORK | No |
| 2 | 207RC0000X | Internal Medicine | Cardiovascular Disease | 179543 | 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 | 133783251 | OTHER | NEW YORK | UNITED HEALTH CARE |
| 2 | 133783251 | OTHER | NEW YORK | MULTIPLAN |
| 3 | 0537413 | OTHER | NEW YORK | AETNA HMO |
| 4 | 2654 | OTHER | NEW YORK | CONNECTICARE |
| 5 | 88F971 | OTHER | NEW YORK | EMPIRE BLUE CROSS/SHEILD |
| 6 | 133783251 | OTHER | NEW YORK | BEECH STREET |
| 7 | NP1023 | OTHER | NEW YORK | OXFORD & OXFORD MCR |
| 8 | O60032868 | OTHER | NEW YORK | RAILROAD MCR |
| 9 | 133783251 | OTHER | NEW YORK | CHN |
| 10 | 133783251 | OTHER | NEW YORK | PHCS |
| 11 | 133783251 | OTHER | NEW YORK | POMCO |
| 12 | 2101340 | OTHER | NEW YORK | GHI |
| 13 | 1C4452 | OTHER | NEW YORK | HEALTHNET |
| 14 | 4618635 | OTHER | NEW YORK | AETNA PPO |
| 15 | F25024 | MEDICARE UPIN | NEW YORK | |
| 16 | 7141114-004 | OTHER | NEW YORK | CIGNA |
| 17 | 133783251 | OTHER | NEW YORK | HORIZON HEALTHCARE OF NY |
| 18 | 17697 | OTHER | NEW YORK | GHI HMO |
