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 | 213ES0131X | Podiatrist | Foot Surgery | SC001976-L | 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 | ========= | OTHER | OHIO | STATEFARM HEALTH INS |
| 2 | ========= | OTHER | OHIO | UNITED COMMERICAL TRAVELE |
| 3 | ========= | OTHER | PENNSYLVANIA | PA EMPLOYES BENEFIT TRUST |
| 4 | T72352 | MEDICARE UPIN | PENNSYLVANIA | |
| 5 | 25363650 | OTHER | FLORIDA | PENN TREATY NETWORK AM IN |
| 6 | ========= | OTHER | FLORIDA | AMERICAN GENERAL LIFE & A |
| 7 | 21298 | OTHER | PENNSYLVANIA | GEISSINGER HEALTH PLAN |
| 8 | 0004390700 | OTHER | TEXAS | AETNA |
| 9 | 1000010001========= | OTHER | PENNSYLVANIA | UNITED HEALTHCARE INS CO |
| 10 | 338060 | OTHER | WASHINGTON | COMBINED INSURANCE CO OF |
| 11 | 335768 | OTHER | PENNSYLVANIA | HEALTH AMERICA PENNSYLVAN |
| 12 | ========= | OTHER | TEXAS | V.A. FINANCIAL SERVICES C |
| 13 | 50001941 | OTHER | PENNSYLVANIA | CAPITAL BLUE CROSS |
| 14 | ========= | OTHER | FLORIDA | GENWORTH FINANCIAL |
| 15 | 001522 | MEDICARE PIN | PENNSYLVANIA | |
| 16 | 1295443 | OTHER | TEXAS | AAG BENEFIT PLAN ADMINIST |
| 17 | ========= | OTHER | PENNSYLVANIA | HOP ADMINISTRATION UNIT |
