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 | 207V00000X | Obstetrics & Gynecology | | 221179 | MASSACHUSETTS | 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 | 0000000028929 | OTHER | | BOSTON MEDICAL CENTER - H |
| 2 | 2070014 | MEDICAID | MASSACHUSETTS | |
| 3 | J27723 | OTHER | | BLUE CARE 65 |
| 4 | 043202198 | OTHER | | GREAT WEST HEALTH PLAN |
| 5 | 043202198 | OTHER | | CONSOLIDATED HEALTH PLAN |
| 6 | 043202198 | OTHER | | FIRST HEALTH |
| 7 | 043202198 | OTHER | | BEACH STREET |
| 8 | 14838 | OTHER | | HARVARD/PILGRIM |
| 9 | J27723 | OTHER | | BLUE CROSS BLUE SHEILD |
| 10 | 77086 | OTHER | | CHILDRENS MEDICAL PLAN |
| 11 | 001413666 | MEDICAID | CONNECTICUT | |
| 12 | 043202198 | OTHER | | HEALTH CARE VALUE MANAGEM |
| 13 | 043202198 | OTHER | | HMC - PPO |
| 14 | 7479928 | OTHER | | CIGNA |
| 15 | 043202198 | OTHER | | CBA |
| 16 | 041366 | OTHER | | CONNECTICARE OF MA |
| 17 | 34835 | OTHER | | HEALTH NEW ENGLAND |
