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 | 207L00000X | Anesthesiology | | | | No |
| 2 | 207N00000X | Dermatology | | | | No |
| 3 | 207P00000X | Emergency Medicine | | | | No |
| 4 | 207RC0200X | Internal Medicine | Critical Care Medicine | | | No |
| 5 | 207RI0011X | Internal Medicine | Interventional Cardiology | | | No |
| 6 | 207RI0200X | Internal Medicine | Infectious Disease | | | No |
| 7 | 207RP1001X | Internal Medicine | Pulmonary Disease | | | No |
| 8 | 207T00000X | Neurological Surgery | | | | No |
| 9 | 208000000X | Pediatrics | | | | No |
| 10 | 2084N0400X | Psychiatry & Neurology | Neurology | | | No |
| 11 | 208600000X | Surgery | | | | Yes |
| 12 | 208M00000X | Hospitalist | | | | No |
| 13 | 261QE0700X | Clinic/Center | End-Stage Renal Disease (ESRD) Treatment | | | No |
| 14 | 291U00000X | Clinical Medical Laboratory | | | PENNSYLVANIA | No |
| 15 | 332B00000X | Durable Medical Equipment & Medical Supplies | | | | No |