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 | 207RC0200X | Internal Medicine | Critical Care Medicine | 2063691 | NEW YORK | No |
| 2 | 207RS0012X | Internal Medicine | Sleep Medicine | 206369 | NEW YORK | No |
| 3 | 207R00000X | Internal Medicine | | 206369 | NEW YORK | No |
| 4 | 207RP1001X | Internal Medicine | Pulmonary Disease | 2063691 | 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 | | BEECH STREET NETWORK |
| 2 | 132995699 | OTHER | | FEDELIS MEDICAID HMO |
| 3 | H16566 | MEDICARE UPIN | | |
| 4 | 132995699 | OTHER | | HEATLH NOW |
| 5 | 132995699 | OTHER | | HUDSON HEALTH PLAN MCD |
| 6 | 132995699 | OTHER | | LOCAL 1199 |
| 7 | 0D2071 | OTHER | | HEALTHNET OF THE NORTHEAS |
| 8 | 132995699 | OTHER | | HORIZON HEALTHCARE OF NY |
| 9 | 132995699 | OTHER | | MAGNACARE PPO |
| 10 | 02155053 | MEDICAID | NEW YORK | |
| 11 | 1C4591 | OTHER | | BCBS EMPIRE |
| 12 | 2596421 | OTHER | | GHI ALL PLANS EXCEPT HMO |
| 13 | 0053968 | OTHER | | GHI HMO |
| 14 | 132995599 | OTHER | | CIGNA PPO |
| 15 | 132995699 | OTHER | | INDECS ORANGE ULSTER SCHL |
| 16 | 2522147 | OTHER | | AETNA USHC |
| 17 | 33353P | OTHER | | HIP |
| 18 | 7588161 | OTHER | | AETNA |
| 19 | 1C4591 | MEDICARE ID-TYPE UNSPECIFIED | | |
| 20 | 132995699 | OTHER | | FAM HEALTH PLUS |
