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 | 202C00000X | Independent Medical Examiner | | | | No |
2 | 204C00000X | Neuromusculoskeletal Medicine, Sports Medicine | | | | No |
3 | 204D00000X | Neuromusculoskeletal Medicine & OMM | | | | No |
4 | 2080S0010X | Pediatrics | Sports Medicine | | | No |
5 | 2081H0002X | Physical Medicine & Rehabilitation | Hospice and Palliative Medicine | | | No |
6 | 2081N0008X | Physical Medicine & Rehabilitation | Neuromuscular Medicine | | | No |
7 | 2081P0004X | Physical Medicine & Rehabilitation | Spinal Cord Injury Medicine | | | No |
8 | 2081P0010X | Physical Medicine & Rehabilitation | Pediatric Rehabilitation Medicine | | | No |
9 | 2081P2900X | Physical Medicine & Rehabilitation | Pain Medicine | | | No |
10 | 2081S0010X | Physical Medicine & Rehabilitation | Sports Medicine | | | No |
11 | 2083X0100X | Preventive Medicine | Occupational Medicine | | | No |
12 | 208VP0000X | Pain Medicine | Pain Medicine | | | No |
13 | 208VP0014X | Pain Medicine | Interventional Pain Medicine | | | No |
14 | 209800000X | Legal Medicine | | | | No |
15 | 208100000X | Physical Medicine & Rehabilitation | | | | 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 | 6183470001 | MEDICARE NSC | NEW JERSEY | |