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 | 207RP1001X | Internal Medicine | Pulmonary Disease | 135143 | 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 | 0672649005 | OTHER | | CIGNA HMO, POS |
| 2 | 123213 | OTHER | | AETNA/USHC |
| 3 | 132995699 | OTHER | | LOCAL 1199 |
| 4 | 0D0735 | OTHER | | HEALTHNET OF NORTHEAST |
| 5 | 132995699 | OTHER | | CIGNA PPO |
| 6 | 132995699 | OTHER | | INDECS(ORANGE-ULSTER SCHL |
| 7 | OX1379 | OTHER | | HIP |
| 8 | 132995699 | OTHER | | BEECH STREET NETWORK |
| 9 | 132995699 | OTHER | | FIDELIS (MEDICAID HMO) |
| 10 | 132995699 | OTHER | | HORIZON HEALTHCARE OF NY |
| 11 | 132995699 | OTHER | | HEALTH NOW |
| 12 | 58A091 | OTHER | | BC/BS EMPIRE |
| 13 | 132995699 | OTHER | | FAM HEALTH PLUS(HUDSON HP |
| 14 | 00913240 | MEDICAID | NEW YORK | |
| 15 | 132995699 | OTHER | | HUDSON HEALTH PLAN |
| 16 | 132995699 | OTHER | | MAGNACARE PPO |
| 17 | 2900090 | OTHER | | GHI |
| 18 | 4458461 | OTHER | | AETNA |
