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 | 1223G0001X | Dentist | General Practice | 037586 | NEW YORK | No |
| 2 | 261QS1200X | Clinic/Center | Sleep Disorder Diagnostic | 037586 | NEW YORK | No |
| 3 | 332B00000X | Durable Medical Equipment & Medical Supplies | | 037586 | NEW YORK | No |
| 4 | 332BC3200X | Durable Medical Equipment & Medical Supplies | Customized Equipment | 037586 | NEW YORK | No |
| 5 | 1223P0700X | Dentist | Prosthodontics | 037586 | NEW YORK | Yes |