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 | 207RP1001X | Internal Medicine | Pulmonary Disease | 24140 | NEW JERSEY | 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 | 1028538 | OTHER | NEW JERSEY | HORIZON NJ HEALTH |
| 2 | 551533 | OTHER | NEW JERSEY | AMERIHEALTH |
| 3 | CF1767 | OTHER | NEW JERSEY | RAIL ROAD MEDICARE |
| 4 | 1028538 | OTHER | NEW JERSEY | MERCY HEALTH |
| 5 | 221943736 | OTHER | NEW JERSEY | THE MAIL HANDLERS BENEFIT |
| 6 | 221943736-004 | OTHER | NEW JERSEY | ST BARNABAS HEALTH PLAN |
| 7 | 221943736 | OTHER | NEW JERSEY | HORIZON BLUE SHIELD |
| 8 | P416870 | OTHER | NEW JERSEY | OXFORD |
| 9 | 221943736 | OTHER | NEW JERSEY | QUALCARE |
| 10 | 221943736 | OTHER | NEW JERSEY | UNITED HEALTHCARE |
| 11 | 000596512 | OTHER | NEW JERSEY | APWU HEALTH PLAN |
| 12 | 023249-1 | OTHER | NEW JERSEY | UNIVERSITY HEALTH PLAN |
| 13 | 5879335 | OTHER | NEW JERSEY | CIGNA |
| 14 | F01045 | OTHER | NEW JERSEY | HEALTHNET |
| 15 | 1008200 | MEDICAID | NEW JERSEY | |
| 16 | 221943736 | OTHER | NEW JERSEY | PRIVATE HEALTHCARE SYSTEM |
| 17 | 526101 | OTHER | NEW JERSEY | AETNA |
| 18 | 71337 | OTHER | NEW JERSEY | EMPIRE BLUE |
