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 | 207Q00000X | Family Medicine | | 171781 | NEW YORK | No |
| 2 | 208100000X | Physical Medicine & Rehabilitation | | 187122-1 | NEW YORK | No |
| 3 | 207RC0000X | Internal Medicine | Cardiovascular Disease | 165520 | NEW YORK | No |
| 4 | 204C00000X | Neuromusculoskeletal Medicine, Sports Medicine | | 187122-1 | NEW YORK | No |
| 5 | 2081S0010X | Physical Medicine & Rehabilitation | Sports Medicine | 187122-1 | NEW YORK | No |
| 6 | 2083P0901X | Preventive Medicine | Public Health & General Preventive Medicine | 165520 | NEW YORK | No |
| 7 | 2083T0002X | Preventive Medicine | Medical Toxicology | 165520 | NEW YORK | Yes |