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 | 332B00000X | Durable Medical Equipment & Medical Supplies | | | | 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 | 000031396201 | OTHER | NEW YORK | UNIVERA |
| 2 | 8291475 | OTHER | NEW YORK | INDEPENDENT HEALTH |
| 3 | TIN | OTHER | NEW YORK | FEDELIS |
| 4 | 00820001272 | OTHER | NEW YORK | EMPIRE |
| 5 | P0170059DM | OTHER | NEW YORK | EXCELLUS BLUE SHIELD |
| 6 | TIN | OTHER | NEW YORK | TRICARE |
| 7 | TIN | OTHER | NEW YORK | CHAMPVA |
| 8 | TIN | OTHER | NEW YORK | NEW YORK STATE WORKMAN'S COMP |
| 9 | 000419218001 | OTHER | NEW YORK | BLUE CROSS & BLUE SHIELD OF WESTERN NEW YORK |
| 10 | P1070059DS | OTHER | NEW YORK | EXCELLUS BLUE CHOICE |
| 11 | TIN | OTHER | NEW YORK | POMCO |
| 12 | TIN | OTHER | NEW YORK | HME NATIONAL NETWORK |
| 13 | 5811550002 | MEDICARE NSC | NEW YORK | |
| 14 | 00820001272 | OTHER | NEW YORK | UNITED HEALTHCARE |
| 15 | TIN | OTHER | NEW YORK | NEW YORK STATE INSURANCE FUND |
| 16 | 9008369 | OTHER | NEW YORK | AETNA |
| 17 | TIN | OTHER | NEW YORK | HUMANA |
| 18 | 17351 | OTHER | NEW YORK | MVP |
| 19 | TIN | OTHER | NEW YORK | RSMCO |
| 20 | 02885894 | MEDICAID | NEW YORK | |
