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 | 2085R0001X | Radiology | Radiation Oncology | 206193-1 | NEW YORK | 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 | 131740118 | OTHER | | ATLANTIS |
| 2 | 01748181 | MEDICAID | NEW YORK | |
| 3 | 1000017634 | OTHER | | AFFINITY HEALTH PLAN |
| 4 | 10102758 | OTHER | | CHPHP U104 |
| 5 | 131740118 | OTHER | | CCN |
| 6 | 131740118 | OTHER | | CHN SOLUTIONS |
| 7 | 2443E1 | OTHER | | BCBS SENIOR PLAN |
| 8 | 1096618 | OTHER | NEW YORK | AETNA HMO |
| 9 | 4193159 | OTHER | | GHI PPO |
| 10 | 131740118 | OTHER | | BEECH STREET |
| 11 | 131740118 | OTHER | | FIRST HEALTH |
| 12 | 2443E1 | OTHER | | BCBS |
| 13 | 000551340101 | OTHER | NEW YORK | HEALTH PLUSE (YONKERS) |
| 14 | 000551340102 | OTHER | NEW YORK | HEALTH PLUS (BRONX) |
| 15 | 8237219 | OTHER | | CIGNA |
| 16 | 5597619 | OTHER | NEW YORK | AETNA PPO |
| 17 | 131740118 | OTHER | | GALAXY |
| 18 | 930531L091 | MEDICARE PIN | NEW YORK | |
| 19 | 131740118 | OTHER | | CIGNA |
| 20 | 131740118 | OTHER | | COMMUNITY CHOICE |
| 21 | 131740118 | OTHER | | DEVON |
| 22 | 930531L093 | MEDICARE PIN | NEW YORK | |
