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 | | 204892 | 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 | J22441 | OTHER | | BLUE SHIELD |
| 2 | 043517461 | OTHER | | GIC INDEMNITY PLAN |
| 3 | 043517461 | OTHER | | CIGNA |
| 4 | 043517461 | OTHER | | HCVM FIRST HEALTH |
| 5 | 10043384 | OTHER | | CAPITAL DISTRICT PHP |
| 6 | 131258 | OTHER | | HARVARD COMM HEALTH |
| 7 | A31176 | MEDICARE ID-TYPE UNSPECIFIED | MASSACHUSETTS | |
| 8 | 043517461 | OTHER | | CHAMPUS |
| 9 | H18200 | MEDICARE UPIN | | |
| 10 | J22441 | OTHER | | HMO BLUE |
| 11 | 0020652 | OTHER | | NEIGHBORHOOD HEALTH PLAN |
| 12 | 000000022181 | OTHER | | BMC HEALTH NET PLAN |
| 13 | 043517461 | OTHER | | HMC PPO |
| 14 | 160053244 | OTHER | | MEDICARE RAILROAD |
| 15 | 26372 | OTHER | | HEATH NEW ENGLAND |
| 16 | 3148787 | OTHER | | AETNA |
| 17 | 153355 | OTHER | | MVP SELECT |
| 18 | 44819 | OTHER | | HEALTHY START |
| 19 | 043517461 | OTHER | | NO AMERICAN ADMIN |
| 20 | 0102831 | MEDICAID | MASSACHUSETTS | |
