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 | 208000000X | Pediatrics | | 197249 | 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 | 197249A85 | OTHER | NEW YORK | HEALTH FIRST HEALTH PLAN |
| 2 | 219990 | OTHER | NEW YORK | WELLCARE OF NY MEDICAL PL |
| 3 | 11227421 | OTHER | NEW YORK | MULTI HEALTH PLAN |
| 4 | 197249NY | OTHER | NEW YORK | 1199 HEALTH PLAN |
| 5 | 212752 | OTHER | NEW YORK | WELLCARE NY MEDICAL PLAN |
| 6 | 5B865 | OTHER | NEW YORK | BLUECROSS BLUE SHIELD HEA |