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 | 225100000X | Physical Therapist | | 40QA00466300 | 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 | 1602579 | OTHER | NEW JERSEY | AMERIHEALTH PPO |
2 | 1347424 | OTHER | NEW JERSEY | UNITED HEALTHCARE |
3 | 1602584 | OTHER | NEW JERSEY | AMERIHEALTH HMO GROUP # |
4 | 223305571 | OTHER | NEW JERSEY | AETNA |
5 | 532743 | MEDICARE ID-TYPE UNSPECIFIED | NEW JERSEY | MEDICARE NJ |
6 | 223305571 | OTHER | NEW JERSEY | HORIZON BLUE SHIELD GRP # |
7 | 2281152000 | OTHER | NEW JERSEY | AMERIHEALTH HMO |
8 | 2K3845 | OTHER | NEW JERSEY | HEALTHNET |
9 | DD2634 | OTHER | NEW JERSEY | RAILROAD MEDICARE GROUP # |
10 | P853305 | OTHER | NEW JERSEY | OXFORD |
11 | 0822480001 | OTHER | NEW JERSEY | DMERC A |
12 | 223305571 | OTHER | NEW JERSEY | TRICARE / CHAMPUS GROUP # |
13 | 223305571 | OTHER | NEW JERSEY | CIGNA |
14 | 58001 | OTHER | NEW JERSEY | CIGNA |
15 | 650010941 | OTHER | NEW JERSEY | RAILROAD MEDICARE PIN |
16 | 223305571 | OTHER | NEW JERSEY | HORIZON MERCY HP GROUP # |
17 | 650010941 | MEDICARE PIN | NEW JERSEY | |