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 | 2085R0202X | Radiology | Diagnostic Radiology | MD423472 | PENNSYLVANIA | No |
| 2 | 2085R0202X | Radiology | Diagnostic Radiology | ME125081 | FLORIDA | Yes |
| 3 | 2085R0202X | Radiology | Diagnostic Radiology | MD11832 | RHODE ISLAND | No |
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 | 412652 | OTHER | RHODE ISLAND | BLUE CHIP TGR |
| 2 | 494201 | OTHER | RHODE ISLAND | TUFTS TGR |
| 3 | 7417697 | OTHER | RHODE ISLAND | AETNA OFFICE TGR |
| 4 | 2203 | OTHER | RHODE ISLAND | NHP TGR |
| 5 | 7057871 | MEDICAID | RHODE ISLAND | |
| 6 | P00272151 | OTHER | RHODE ISLAND | RR MEDICARE TGR |
| 7 | 16-00137 | OTHER | RHODE ISLAND | UHC TGR |
| 8 | 1570-5 | OTHER | RHODE ISLAND | BCBS KENT TGR |
| 9 | 50356624 | OTHER | RHODE ISLAND | UNICARE LIFE & HLTH TGR |
| 10 | 1198-5 | OTHER | RHODE ISLAND | BCBS OFFICE TGR |
| 11 | AA42348 | OTHER | RHODE ISLAND | HARVARD PILGRIM TGR |
| 12 | 756624 | OTHER | RHODE ISLAND | CONNECTICARE INC TGR |
