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 | 213ES0131X | Podiatrist | Foot Surgery | DPM00281 | RHODE ISLAND | 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 | 204928511 | OTHER | RHODE ISLAND | UNITED HEALTH CARE |
| 2 | 580173 | OTHER | | GENERIC3 GROUP NUMBER |
| 3 | 5807131 | OTHER | RHODE ISLAND | AETNA COMMERCIAL |
| 4 | U61582 | MEDICARE UPIN | RHODE ISLAND | |
| 5 | 0000007213 | OTHER | | GENERIC4 GROUP NUMBER |
| 6 | 1358850 | OTHER | RHODE ISLAND | AETNA HMO |
| 7 | 2944 | OTHER | | NEIGHBORHOOD HEALTH PLANS |
| 8 | 480020466 | OTHER | | GENERIC7 |
| 9 | 1164100001 | OTHER | | GENERIC6 |
| 10 | 9146868001 | OTHER | | CIGNA |
| 11 | 400540 | OTHER | | BLUE CHIP GROUP NUMBER |
| 12 | 7008235 | MEDICAID | RHODE ISLAND | |
| 13 | PT SSN # | OTHER | RHODE ISLAND | TRI CARE |
| 14 | 583173 | OTHER | | GENERIC3 |
| 15 | 164100001 | OTHER | RHODE ISLAND | RAILROAD MEDICARE |
| 16 | 400540 | OTHER | RHODE ISLAND | BLUE CHIP RI |
| 17 | 007058720 | MEDICARE PIN | RHODE ISLAND | |
| 18 | 0000031649 | OTHER | RHODE ISLAND | BCBC OF RI |
| 19 | AA69500 | OTHER | RHODE ISLAND | HARVARD PILGRIM |
| 20 | 9146868001 | OTHER | | CIGNA GROUP NUMBER |
