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 | 207RC0000X | Internal Medicine | Cardiovascular Disease | MA47669 | NEW JERSEY | Yes |
2 | 207RC0000X | Internal Medicine | Cardiovascular Disease | MD072350L | PENNSYLVANIA | 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 | CA0000169 00 | OTHER | NEW JERSEY | AMERICHOICE |
2 | 060047034 | OTHER | NEW JERSEY | RSAILROAD MEDICARE |
3 | 1491504 | MEDICAID | NEW JERSEY | |
4 | 3K5948 | OTHER | NEW JERSEY | HEALTHNET, INC |
5 | 1860005 | OTHER | NEW JERSEY | UNITED HEALTH CARE |
6 | P430257 | OTHER | NEW JERSEY | OXFORD HEALTH PLAN |
7 | 852690 | OTHER | NEW JERSEY | AETNA US HEALTHCARE |
8 | 0198224 | OTHER | NEW JERSEY | CIGNA |
9 | 0369546000 | OTHER | NEW JERSEY | AMERIHEALTH HMO |
10 | 1066074 | OTHER | NEW JERSEY | HORIZON NJ HEALTH |
11 | 186000504 | OTHER | NEW JERSEY | UNITED HEALTH CARE |
12 | 18925 | OTHER | NEW JERSEY | UNIVERSITY HEALTH PLAN |
13 | 551668 | OTHER | NEW JERSEY | AMERIHEALTH PPO PABS |