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 | 251G00000X | Hospice Care, Community Based | | 22747 | NEW JERSEY | No |
| 2 | 251G00000X | Hospice Care, Community Based | | 22440 | NEW JERSEY | 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 | 1027553 | OTHER | NEW JERSEY | AETNA |
| 2 | 311533 | OTHER | NEW JERSEY | EMPIRE BLUE CROSS BLUE SH |
| 3 | 311533 | OTHER | NEW JERSEY | UNITED HEALTHCARE |
| 4 | 311533 | OTHER | NEW JERSEY | DEVON |
| 5 | IL8654 | OTHER | NEW JERSEY | HEALTHNET INPATIENT AND R |
| 6 | 206864 | OTHER | NEW JERSEY | UNIFORM FAMILY HEALTH SER |
| 7 | 311533B | OTHER | NEW JERSEY | FIRST HEALTH |
| 8 | 40682 | OTHER | NEW JERSEY | AMERIGROUP |
| 9 | 7860200 | MEDICAID | NEW JERSEY | |
| 10 | A896553 | OTHER | NEW JERSEY | OXFORD |
| 11 | 1077948 | OTHER | NEW JERSEY | HORIZON NJ HEALTHCARE MER |
| 12 | 2K0104 | OTHER | NEW JERSEY | HEALTHNET ROUTINE |
| 13 | 311533B | OTHER | NEW JERSEY | PHCS |
| 14 | 311533 | OTHER | NEW JERSEY | HORIZON BLUE CROSS BLUE S |
| 15 | 311533 | OTHER | NEW JERSEY | AMERICHOICE |
