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 | 208000000X | Pediatrics | | OS014569 | PENNSYLVANIA | 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 | 2324834 05 | OTHER | NEW YORK | UNITED HEALTH CARE |
| 2 | 26N2812 | OTHER | NEW YORK | NEIGHBORHOOD HEALTH |
| 3 | 3235937 | OTHER | NEW YORK | AETNA USHC HMO |
| 4 | LE3073 | OTHER | NEW YORK | ATLANTIS HEALTH PLAN |
| 5 | 7215464 | OTHER | NEW YORK | AETNA PPO |
| 6 | 0101236-02 | OTHER | NEW YORK | AMERICHOICE |
| 7 | 159350201 | OTHER | NEW YORK | HEALTH PLUS |
| 8 | 3K1871 | MEDICARE ID-TYPE UNSPECIFIED | NEW YORK | |
| 9 | I01732 | MEDICARE UPIN | NEW YORK | |
| 10 | 3C4213 | OTHER | NEW YORK | HEALTH NET |
| 11 | 223073-A15 | OTHER | NEW YORK | HEALTH FIRST |
| 12 | 11-3491197 | OTHER | NEW YORK | HORIZON HEALTHCARE NY |
| 13 | P2913179 | OTHER | NEW YORK | OXFORD HEALTH PLAN |
| 14 | 02405329 | MEDICAID | NEW YORK | |
