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 | 213E00000X | Podiatrist | | N005167 | 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 | CS1042 | OTHER | | OXFORD |
| 2 | P2098270 | OTHER | NEW YORK | OXFORD |
| 3 | 113261797 | OTHER | NEW YORK | MAGNACARE INS CO |
| 4 | 20-5783751 | OTHER | NEW YORK | UNITED HEALTHCARE |
| 5 | PL8471 | OTHER | NEW YORK | BLUE CROSS BLUE SHIELD |
| 6 | 113261797 | OTHER | | UNITED HEALTH CARE |
| 7 | 20-5783751 | OTHER | NEW YORK | MAGNA CARE |
| 8 | 480020565 | OTHER | | RAILROAD MEDICARE |
| 9 | P04563 | OTHER | NEW YORK | WORKERS COMPENSATION |
| 10 | P05167 | OTHER | | WORKERS COMPENSATION |
| 11 | P7462 | OTHER | | EMPIRE BLUE CHOICE |
| 12 | 113261797 | OTHER | | CIGNA |
| 13 | 480024842 | OTHER | NEW YORK | RAILROAD MEDICARE |
| 14 | 4C3351 | OTHER | NEW YORK | HEALTHNET |
| 15 | U56045 | MEDICARE UPIN | | |
| 16 | 113261797 | OTHER | | EMPIRE PLAN (NYS EMPLOYEE |
| 17 | P12581 | OTHER | | BLUE CROSS/BLUE SHIELD |
| 18 | P12581 | MEDICARE PIN | NEW YORK | |
| 19 | P1258ZZRQ1 | MEDICARE PIN | NEW YORK | |
