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 | 1319150 | 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 | 132995699 | OTHER | | FIDEUS (MEDICAID HMO) |
| 2 | 132995699 | OTHER | | INDECS(ORANGE-ULSTER SCHL |
| 3 | 132995699 | OTHER | | LOCAL 1199 |
| 4 | 132998699 | OTHER | | HORIZON HEALTHCARE OF NY |
| 5 | B13071 | MEDICARE UPIN | | |
| 6 | 132995699 | OTHER | | HEALTHNOW |
| 7 | 132995699 | OTHER | | HUDSON HEALTH PLAN |
| 8 | 2900089 | OTHER | | GHI |
| 9 | 327611 | MEDICARE ID-TYPE UNSPECIFIED | | |
| 10 | 535171006 | OTHER | | CIGNA HMO, POS |
| 11 | 4286895 | OTHER | | AETNA |
| 12 | 327611 | OTHER | | BC/BS EMPIRE |
| 13 | 132995699 | OTHER | | FAM HEALTH PLUS(HUDSON HP |
| 14 | 132995699 | OTHER | | MAGNACARE PPO |
| 15 | 1902892326 | OTHER | | NPI |
| 16 | 132995699 | OTHER | | CIGNA PPO |
| 17 | 123212 | OTHER | | AETNA/USHC |
| 18 | 0D0737 | OTHER | | HEALTHNET OF NORTHEAST |
| 19 | OX140P | OTHER | | HIP |
| 20 | 132995699 | OTHER | | BEECH STREET NETWORK |
| 21 | 00533000 | MEDICAID | NEW YORK | |
