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 | 207W00000X | Ophthalmology | | 169538 | 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 | 00020324001 | OTHER | NEW YORK | UNIVERA |
| 2 | C58085 | MEDICARE UPIN | NEW YORK | |
| 3 | RC60169538 | OTHER | NEW YORK | DOCTORS HEALTH PLAN |
| 4 | 005231231 | OTHER | NEW YORK | BLUE SHIELD WESTERN NY |
| 5 | P010169538 | OTHER | NEW YORK | BLUE SHIELD OF ROCHESTER |
| 6 | 005231231 | OTHER | NEW YORK | COMMUNITY BLUE |
| 7 | 01019052 | MEDICAID | NEW YORK | |
| 8 | P010169538 | OTHER | NEW YORK | BLUE CHOICE |
| 9 | 101176CR | OTHER | NEW YORK | PREFERRED CARE |
| 10 | 169538-6 (C-O) | OTHER | NEW YORK | NYS WORKMANS COMP. |
| 11 | 9609398 | OTHER | NEW YORK | GHI |
| 12 | 11554B | MEDICARE PIN | NEW YORK | |
