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 | 225X00000X | Occupational Therapist | | | | 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 | 00011249902 | OTHER | | ASO |
| 2 | 00011249902 | OTHER | | UNIVERA COMMERCIAL |
| 3 | RA1295 | MEDICARE ID-TYPE UNSPECIFIED | | |
| 4 | 000670011001 | OTHER | | CB LABOR HEALTH HMO |
| 5 | 000733832001 | OTHER | | COMMUNITY CARE |
| 6 | 040511000063 | OTHER | | FIDELIS MEDICAID |
| 7 | 040511000063 | OTHER | | NORTH AMERICAN PREFERRED |
| 8 | 1600573 | OTHER | | GROUP HEALTH INS PPO CBP |
| 9 | 00011249902 | OTHER | | UNIVERA HEALTHCARE TRAD |
| 10 | 7400120 | OTHER | | AETNA |
| 11 | 000670011001 | OTHER | | BC BS WNY |
| 12 | 000670011001 | OTHER | | TRADITIONAL SECURE BLUE |
| 13 | 040511000063 | OTHER | | FIDELIS CHILD HEALTH PLUS |
| 14 | 000670011001 | OTHER | | CB ADVANTAGE HMO |
| 15 | 040511000063 | OTHER | | FIDELIS FAMILY HEALTH PLU |
| 16 | 000670011001 | OTHER | | CHP FHP 201 |
| 17 | 01465154 | MEDICAID | NEW YORK | |
| 18 | 0000670011001 | OTHER | | COMMUNITY BLUE STD HMO |
