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 | 208600000X | Surgery | | 285970 | NEW YORK | No |
| 2 | 208600000X | Surgery | | 25MA09650900 | NEW JERSEY | No |
| 3 | 208600000X | Surgery | | MD482413 | PENNSYLVANIA | No |
| 4 | 2086S0102X | Surgery | Surgical Critical Care | 285970 | NEW YORK | No |
| 5 | 2086S0102X | Surgery | Surgical Critical Care | 25MA09650900 | NEW JERSEY | No |
| 6 | 2086S0102X | Surgery | Surgical Critical Care | MD482413 | PENNSYLVANIA | No |
| 7 | 2086S0127X | Surgery | Trauma Surgery | 285970 | NEW YORK | No |
| 8 | 2086S0127X | Surgery | Trauma Surgery | MD482413 | PENNSYLVANIA | No |
| 9 | 2086S0127X | Surgery | Trauma Surgery | 25MA09650900 | NEW JERSEY | Yes |