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 | 163W00000X | Registered Nurse | | 470128-1 | NEW YORK | No |
| 2 | 163W00000X | Registered Nurse | | 470128 | NEW YORK | No |
| 3 | 163WC0400X | Registered Nurse | Case Management | 470128 | NEW YORK | No |
| 4 | 163WC1500X | Registered Nurse | Community Health | 470128-1 | NEW YORK | No |
| 5 | 163WC1500X | Registered Nurse | Community Health | 470128 | NEW YORK | No |
| 6 | 163WC3500X | Registered Nurse | Cardiac Rehabilitation | 470128 | NEW YORK | No |
| 7 | 163WG0000X | Registered Nurse | General Practice | 470128-1 | NEW YORK | Yes |
| 8 | 163WG0000X | Registered Nurse | General Practice | 470128 | NEW YORK | No |
| 9 | 163WH0200X | Registered Nurse | Home Health | 470128 | NEW YORK | No |
| 10 | 163WH1000X | Registered Nurse | Hospice | 470128 | NEW YORK | No |
| 11 | 163WI0500X | Registered Nurse | Infusion Therapy | 470128-1 | NEW YORK | No |
| 12 | 163WI0500X | Registered Nurse | Infusion Therapy | 470128 | NEW YORK | No |
| 13 | 163WN1003X | Registered Nurse | Nutrition Support | 470128 | NEW YORK | No |
| 14 | 163WP0808X | Registered Nurse | Psychiatric/Mental Health | 470128 | NEW YORK | No |
| 15 | 163WP2201X | Registered Nurse | Ambulatory Care | 470128 | NEW YORK | 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 | 01785148 | MEDICAID | NEW YORK | |
