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 | 207RC0000X | Internal Medicine | Cardiovascular Disease | BP7735535 | NEW JERSEY | 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 | 110231825 | OTHER | NEW JERSEY | RAILROAD MEDIARE |
| 2 | 0340479000 | OTHER | NEW JERSEY | AMERIHEALTH HMO |
| 3 | 3K6050 | OTHER | NEW JERSEY | HEALTHNET, INC |
| 4 | 055266 | MEDICARE PIN | NEW JERSEY | |
| 5 | P2616742 | OTHER | NEW JERSEY | OXFORD HEALTH PLAN |
| 6 | 2748259 | OTHER | NEW JERSEY | AETNA US HEALTHCARE |
| 7 | 8770506 | MEDICAID | NEW JERSEY | |
| 8 | 0340479000 | OTHER | NEW JERSEY | AMERIHEALTH HMO |
| 9 | 33020 | OTHER | NEW JERSEY | UNIVERSITY HEALTH PLAN |
| 10 | 1198011 | OTHER | NEW JERSEY | UNITED HEALTH CARE |
| 11 | 1163020 | OTHER | NEW JERSEY | HORIZON NJ HEALTH |
| 12 | 010003748 00 | OTHER | NEW JERSEY | AMERICHOICE |
| 13 | 482273 | OTHER | PENNSYLVANIA | PENNSYLVANIA BLUE SHIELD |
| 14 | C07713 | MEDICARE UPIN | NEW JERSEY | |
