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 | | 211916 | 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 | 113681295 | OTHER | NEW YORK | HORIZON PROVIDER ID |
| 2 | 211916-A40 | OTHER | NEW YORK | HEALTHFIST PROVIDER ID |
| 3 | 2891530 | OTHER | NEW YORK | AETNA HMO PROVIDER ID |
| 4 | 0402412 | OTHER | NEW YORK | GHI PROVIDER ID |
| 5 | 2165752-004 | OTHER | NEW YORK | CIGNA PROVIDER ID |
| 6 | 05740G | MEDICARE PIN | NEW YORK | |
| 7 | 1000031767 | OTHER | NEW YORK | AFFINITY PROVIDER ID |
| 8 | 113681295 | OTHER | NEW YORK | MAGNACARE PROVIDER ID |
| 9 | 150170301 | OTHER | NEW YORK | HEALTHPLUS PROVIDER ID |
| 10 | 171193 | OTHER | NEW YORK | ELDERPLAN PROVIDER ID |
| 11 | 211916 | OTHER | NEW YORK | HIP PROVIDER ID |
| 12 | 02204337 | MEDICAID | NEW YORK | |
| 13 | SP14185 | OTHER | NEW YORK | CENTERCARE PROVIDER ID |
| 14 | 21222849175 | OTHER | NEW YORK | BEECH STREET PROVIDER ID |
| 15 | 434B5 | OTHER | NEW YORK | EMPIRE BCBS PROVIDER ID |
| 16 | 113681295 | OTHER | NEW YORK | 1199 PROVIDER ID |
| 17 | 7239372 | OTHER | NEW YORK | AETNA PPO PROVIDER ID |
| 18 | 4C5053 | OTHER | NEW YORK | HEALTHNET PROVIDER ID |
| 19 | 113681295LI01 | OTHER | NEW YORK | CAREPLUS PROVIDER ID |
| 20 | 2104114 | OTHER | NEW YORK | FIRST HEALTH PROVIDER ID |
| 21 | H34114 | MEDICARE UPIN | NEW YORK | |
