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 | | 191748 | 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 | 168287 | OTHER | NEW YORK | ELDERPLAN |
| 2 | 01490862 | MEDICAID | NEW YORK | |
| 3 | 20J743 | OTHER | NEW YORK | EMPIRE BCBS |
| 4 | 1000039036 | OTHER | NEW YORK | AFFINITY |
| 5 | 1035150 | OTHER | NEW YORK | FIRST HEALTH |
| 6 | 433B71 | OTHER | NEW YORK | EMPIRE BCBS |
| 7 | 331630101 | OTHER | NEW YORK | HEALTH PLUS KGH |
| 8 | 040426017816 | OTHER | NEW YORK | FIDELIS CARE |
| 9 | 0400770 | OTHER | NEW YORK | GHI COMMERCIAL |
| 10 | 1269964 | OTHER | NEW YORK | UNITED HEALTHCARE |
| 11 | 191748 | OTHER | NEW YORK | LICENSE TO PRACTICE |
| 12 | 191748-A27 | OTHER | NEW YORK | HEALTH FIRST KGH |
| 13 | 191748-B27 | OTHER | NEW YORK | HEALTH FIRST JH |
| 14 | 331630102 | OTHER | NEW YORK | HEALTH PLUS JH |
| 15 | P379*137 | OTHER | NEW YORK | OXFORD |
| 16 | QN00100 | OTHER | NEW YORK | AMERICHOICE |
| 17 | 184622P | OTHER | NEW YORK | HIP KGH |
| 18 | 31590P | OTHER | NEW YORK | HIP JH |
