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 | 2085N0904X | Radiology | Nuclear Radiology | RAD0066 | RHODE ISLAND | No |
| 2 | 2085U0001X | Radiology | Diagnostic Ultrasound | RAD0066 | RHODE ISLAND | No |
| 3 | 2085R0204X | Radiology | Vascular & Interventional Radiology | RAD0066 | RHODE ISLAND | No |
| 4 | 2085D0003X | Radiology | Diagnostic Neuroimaging | RAD0066 | RHODE ISLAND | No |
| 5 | 2085B0100X | Radiology | Body Imaging | RAD0066 | RHODE ISLAND | No |
| 6 | 2085N0700X | Radiology | Neuroradiology | RAD0066 | RHODE ISLAND | No |
| 7 | 2085P0229X | Radiology | Pediatric Radiology | RAD0066 | RHODE ISLAND | No |
| 8 | 2085R0202X | Radiology | Diagnostic Radiology | RAD0066 | RHODE ISLAND | 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 | 309001198 | MEDICARE PIN | RHODE ISLAND | |
| 2 | 9001198 | MEDICAID | RHODE ISLAND | |
| 3 | 1198-5 | OTHER | RHODE ISLAND | BCBS OFFICE PROVIDER NO |
| 4 | 2203 | OTHER | RHODE ISLAND | NEIGHBORHOOD H PLAN PROVI |
| 5 | 50356624 | OTHER | RHODE ISLAND | UNICARE LIFE AND HLTH INS |
| 6 | 2188604 | OTHER | RHODE ISLAND | AETNA OFFICE PROVIDER NO |
| 7 | ========= | OTHER | RHODE ISLAND | HARVARD PILGRIM PROVIDER |
| 8 | 703058 | OTHER | RHODE ISLAND | TUFTS HEALTH PLAN |
| 9 | 1570-5 | OTHER | RHODE ISLAND | BCBS KENT HOSP PROVIDER N |
| 10 | 9001570 | MEDICAID | RHODE ISLAND | |
| 11 | 68453 | OTHER | RHODE ISLAND | CIGNA |
| 12 | 5144133 | OTHER | RHODE ISLAND | AETNA KENT HOSPITAL PROV |
| 13 | 309001570 | MEDICARE PIN | RHODE ISLAND | |
| 14 | CD2379 | OTHER | RHODE ISLAND | RAILROAD MEDICARE |
| 15 | 1742251 | OTHER | RHODE ISLAND | UNITED HEALTHCARE |
