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 | | 25MA07089000 | 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 | 1942421070 | OTHER | NEW JERSEY | GRP NPI SURGAIDE 1, LLC |
| 2 | 96127 | OTHER | NEW JERSEY | AMERIGROUP MEDICAID HMO |
| 3 | 1356533624 | OTHER | NEW JERSEY | GRP NPI SURGAIDE 2, LLC |
| 4 | 01000416910 | OTHER | NEW JERSEY | AMERICHOICE OF NJ |
| 5 | P2843436 | OTHER | NEW JERSEY | OXFORD HEALTHCARE |
| 6 | 1169311 | OTHER | NEW JERSEY | HORIZON NJ HEALTH |
| 7 | 01000416908 | OTHER | NEW JERSEY | AMERICHOICE OF NJ |
| 8 | 0464125 | OTHER | NEW JERSEY | CIGNA |
| 9 | 1790731271 | OTHER | NEW JERSEY | GRP NPI COMPREHENSIVE WOMEN'S HEALTHCARE |
| 10 | 3725083 | OTHER | NEW JERSEY | AETNA |
| 11 | 8327602 | MEDICAID | NEW JERSEY | |
| 12 | 01000416905 | OTHER | NEW JERSEY | AMERICHOICE OF NJ |
| 13 | 01000416900 | OTHER | NEW JERSEY | AMERICHOICE OF NJ |
| 14 | 01000416907 | OTHER | NEW JERSEY | AMERICHOICE OF NJ |
| 15 | 2001661000 | OTHER | NEW JERSEY | AMERIHEALTH |
| 16 | 987D31 | OTHER | NEW YORK | EMPIRE BCBS |
