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 | 111N00000X | Chiropractor | | X008328 | 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 | CO8328-9B | OTHER | NEW YORK | WORKERS COMP BOARD NO. |
| 2 | 50130 | OTHER | NEW YORK | PRISM |
| 3 | 99871 | OTHER | NEW YORK | HEALTH PARTNERS |
| 4 | 0579923003 | OTHER | NEW YORK | CIGNA HEALTHCARE |
| 5 | CO8328-9B | OTHER | NEW YORK | WORKER COMP BOARD SO. |
| 6 | 0579923001 | OTHER | NEW YORK | CIGNA PPO |
| 7 | 1C8150 | OTHER | NEW YORK | HEALTHNET PPO |
| 8 | 5342643 | OTHER | NEW YORK | AETNA US HEALTHCARE |
| 9 | 83289 | OTHER | NEW YORK | SPECIAL FUNDS |
| 10 | 926881 | OTHER | NEW YORK | MANAGED PHYSICAL NETWORK |
| 11 | X92621 | OTHER | NEW YORK | EMPIRE BCBS |
| 12 | 08238 | OTHER | NEW YORK | LANDMARK HEALTHCARE |
| 13 | 83289 | OTHER | NEW YORK | THE PMA GROUP |
| 14 | P515078 | OTHER | NEW YORK | OXFORD |
| 15 | 0579923001 | OTHER | NEW YORK | CIGNA |
| 16 | X92621 | MEDICARE PIN | NEW YORK | |
| 17 | 4366499 | OTHER | NEW YORK | AETNA US HEALTHCARE |
