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 | 207RH0003X | Internal Medicine | Hematology & Oncology | 79814 | MASSACHUSETTS | 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 | J16228 | OTHER | | BLUE CARE ELECT |
| 2 | 4207375 | OTHER | | CIGNA HEALTH PLAN |
| 3 | 784227 | OTHER | | MVP HEALTH CARE |
| 4 | J16228 | OTHER | | BLUE SHIELD HMO BLUE |
| 5 | A20436 | OTHER | | MEDICARE B |
| 6 | 3000106 | OTHER | | EVERCARE |
| 7 | 042472266 | OTHER | | ONE HEALTH PLAN |
| 8 | AZ0436 | MEDICARE ID-TYPE UNSPECIFIED | MASSACHUSETTS | |
| 9 | 3133184 | OTHER | | HEALTHY START |
| 10 | 5420027 | OTHER | | AETNA |
| 11 | 5420027 | OTHER | | US HEALTHCARE |
| 12 | 91688 | OTHER | | FALLON COMM HEALTH PLAN |
| 13 | G09117 | MEDICARE UPIN | | |
| 14 | J16228 | OTHER | | BLUE SHIELD INDEMNITY |
| 15 | 3133184 | OTHER | | MEDICAID WELFARE |
| 16 | 042472266 | OTHER | | HEALTHCARE VALUE MGMT |
| 17 | 1050340 | OTHER | | FIRST HEALTH |
| 18 | 042472266 | OTHER | | PRIVATE HEALTHCARE SYST |
| 19 | AA2308 | OTHER | | HARVARD PILGRIM HLTHCARE |
| 20 | 3133184 | MEDICAID | MASSACHUSETTS | |
