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 | 207W00000X | Ophthalmology | | 127211 | NEW YORK | Yes |
| 2 | 363AS0400X | Physician Assistant | Surgical | 127211 | NEW YORK | No |
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 | 161168030 | OTHER | | FIRST HEALTH |
| 2 | 180041066 | OTHER | | RAILROAD MEDICARE |
| 3 | 7701336 | OTHER | | MVP SELECT CARE |
| 4 | 161168030 | OTHER | | COMMUNITY CARE NETWORK |
| 5 | 161168030 | OTHER | | UNITED HEALTH CARE |
| 6 | 7320096 | OTHER | | AETNA |
| 7 | 161168030 | OTHER | | TRICARE |
| 8 | 7701336 | OTHER | | DOCTORS HEALTH PLAN |
| 9 | P010127211 | OTHER | | EXCELLUS BCBS BLUE CHOICE |
| 10 | 0802 | OTHER | | HEALTHY NY |
| 11 | 000912620001 | OTHER | | HEALTH NOW |
| 12 | 161168030 | OTHER | | GROUP HEALTH INCORPORATED |
| 13 | 0802 | OTHER | | EXCELLUS BCBS |
| 14 | 161168030 | OTHER | | SIDNEY HILLMAN |
| 15 | 161168030 | OTHER | | POMCO |
| 16 | P010127211 | OTHER | | MONROE PLAN |
| 17 | 100751CR | OTHER | | PREFERRED CARE |
| 18 | 161168030 | OTHER | | UNITED HEALTH CARE EMPIRE |
