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 | 207R00000X | Internal Medicine | | 159085 | NEW YORK | No |
| 2 | 207RH0003X | Internal Medicine | Hematology & Oncology | 159085 | 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 | P3715361 | OTHER | NEW YORK | OXFORD HEALTH PLAN |
| 2 | 0553273 | OTHER | NEW YORK | CIGNA HEALTHCARE |
| 3 | 78371 | OTHER | NEW YORK | VYTRA HEALTHCARE |
| 4 | 2Z603 | OTHER | NEW YORK | EMPIRE BLUE CROSS BLUE SH |
| 5 | 7299185 | OTHER | NEW YORK | GHI |
| 6 | 07907 | MEDICARE ID-TYPE UNSPECIFIED | NEW YORK | |
| 7 | P00000070683 | OTHER | NEW YORK | GHI MEDICARE CHOICE PPO |
| 8 | 1201510 | OTHER | NEW YORK | AETNA |
| 9 | 6C0541 | OTHER | NEW YORK | HEALTHNET |
| 10 | P00388302 | OTHER | NEW YORK | RAILROAD MEDICARE |
| 11 | 1569153-1 | OTHER | NEW YORK | 1199 NATIONAL BENEFIT FUN |
| 12 | 01013372 | MEDICAID | NEW YORK | |
| 13 | 159085 | OTHER | NEW YORK | HIP |
| 14 | 2605940 | OTHER | NEW YORK | UNITED HEALTHCARE |
| 15 | 1000016335 | OTHER | NEW YORK | AFFINITY HEALTH PLAN |
| 16 | 137245 | OTHER | NEW YORK | WELLCARE OF NY |
| 17 | 159085-B17 | OTHER | NEW YORK | HEALTH FIRST |
| 18 | 160124 | OTHER | NEW YORK | ELDERPLAN |
| 19 | A65010 | MEDICARE UPIN | NEW YORK | |
