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 | 194057 | 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 | 0000000106124 | OTHER | NEW YORK | GHI HMO PROVIDER ID NUMBE |
| 2 | 001984 | OTHER | | COMMUNITY CHOICE PIN# |
| 3 | 1236475 | OTHER | | AETNA PPO PIN |
| 4 | 222794 | OTHER | NEW YORK | US FAMILY HEALTH PLAN |
| 5 | 4099420 | OTHER | NEW YORK | GHI PPO PROVIDER NUMBER |
| 6 | P3673864 | OTHER | | OXFORD HEALTH PLAN PIN# |
| 7 | 7562022 | OTHER | | AETNA HMO PIN |
| 8 | EMPIRE BCBS | OTHER | | 2486E1 |
| 9 | P00822562 | OTHER | NEW YORK | RAILROAD MEDICARE |
| 10 | 390849 | OTHER | | MVP |
| 11 | 5C6293 | OTHER | | HEALTHNET PIN # |
| 12 | CDPHP PROVIDER PIN# | OTHER | | 10053520 |
| 13 | P3706854 | OTHER | NEW YORK | OXFORD |
| 14 | 02120432 | MEDICAID | NEW YORK | |
