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 | 363LF0000X | Nurse Practitioner | Family | F3343491 | 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 | 000560900001 | OTHER | | CB LABOR HEALTH |
| 2 | 000268570001 | OTHER | | UNIVERA COMMERCIAL |
| 3 | 000560900001 | OTHER | | BCBS WNY |
| 4 | 041116000013 | OTHER | | FIDELIS FAMILY HEALTH PLU |
| 5 | 041116000013 | OTHER | | FIEDLIS CHILD HEALTH PLUS |
| 6 | RA6374 | MEDICARE ID-TYPE UNSPECIFIED | | |
| 7 | 000000092079 | OTHER | | GROUP HEALTH INS HMO |
| 8 | 7599258 | OTHER | | GROUP HEALTH INS PPO CMP |
| 9 | 000560900001 | OTHER | | SENIOR BLUE |
| 10 | G41828 | MEDICARE UPIN | | |
| 11 | 00026857001 | OTHER | | ASO |
| 12 | 000560900001 | OTHER | | COMMUNITY BLUE STANDARD |
| 13 | 000560900001 | OTHER | | CHILD HEALTH PLUS FAMILY |
| 14 | 000560900001 | OTHER | | COMMUNITY CARE |
| 15 | 00056090001 | OTHER | | HMO 100 |
| 16 | 01465154 | MEDICAID | NEW YORK | |
| 17 | 000262857001 | OTHER | | UNIVERA HEALTHCARE TRADIT |
| 18 | 000560900001 | OTHER | | CB ADVANTAGE |
| 19 | 000560900001 | OTHER | | TRADITIONAL SECURE BLUE |
| 20 | 041116000013 | OTHER | | FIDELIS |
