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 | 207RC0000X | Internal Medicine | Cardiovascular Disease | MD040718E | PENNSYLVANIA | No |
| 2 | 207RI0011X | Internal Medicine | Interventional Cardiology | 25MA04835700 | NEW JERSEY | No |
| 3 | 207RI0011X | Internal Medicine | Interventional Cardiology | MD040718E | PENNSYLVANIA | No |
| 4 | 207UN0901X | Nuclear Medicine | Nuclear Cardiology | 25MA04835700 | NEW JERSEY | No |
| 5 | 207UN0901X | Nuclear Medicine | Nuclear Cardiology | MD040718E | PENNSYLVANIA | No |
| 6 | 207RC0000X | Internal Medicine | Cardiovascular Disease | 25MA04835700 | 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 | P420654 | OTHER | | OXFORD HEALTH PLANS |
| 2 | 0382725000 | OTHER | | AMERIHEALTH HMO |
| 3 | 223258770 | OTHER | | AARP HEALTH INSURANCE |
| 4 | 223258770 | OTHER | | BEECHSTREET |
| 5 | 460972 | OTHER | | AETNA US HEALTHCARE |
| 6 | 561376BDF | MEDICARE PIN | NEW JERSEY | |
| 7 | 054273 | MEDICARE PIN | PENNSYLVANIA | |
| 8 | 060022662 | OTHER | | RAILROAD MEDICARE |
| 9 | 223258770 | OTHER | NEW JERSEY | HORZON BCBS OF NJ |
| 10 | 7634102 | MEDICAID | NEW JERSEY | |
| 11 | 223258770 | OTHER | | CIGNA |
| 12 | 223258770 | OTHER | | GHI |
| 13 | 223258770 | OTHER | | GREAT WEST |
| 14 | E22006 | MEDICARE UPIN | | |
| 15 | 0382725000 | OTHER | PENNSYLVANIA | KEYSTONE HEALTH PLANS |
| 16 | 561376 | OTHER | PENNSYLVANIA | BLUE SHIELD PA |
| 17 | 223258770 | OTHER | | DEVON |
| 18 | 223258770 | OTHER | | MAGNA CARE |
| 19 | 0K1810 | OTHER | | HEALTHNET |
| 20 | 561376 | OTHER | | AMERIHEALTH ADMIN PPO |