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 | 2085R0001X | Radiology | Radiation Oncology | 211317 | NEW YORK | No | 
| 2 | 2085R0001X | Radiology | Radiation Oncology | 25MA073922 | NEW JERSEY | 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 | 0099584 | OTHER | NEW JERSEY | GHI | 
| 2 | 2302E1 | OTHER | NEW JERSEY | WELL CHOICE | 
| 3 | 187384 | OTHER | NEW JERSEY | AMERIGROUP | 
| 4 | 2K7880 | OTHER | NEW JERSEY | HEALTHNET | 
| 5 | 1175590 | OTHER | NEW JERSEY | HORIZON NJ HEALTH | 
| 6 | G34657 | MEDICARE UPIN | NEW JERSEY |  | 
| 7 | 058811 | MEDICARE ID-TYPE UNSPECIFIED | NEW JERSEY |  | 
| 8 | 8889503 | MEDICAID | NEW JERSEY |  | 
| 9 | 223522719 | OTHER | NEW JERSEY | UNITED HEALTHCARE | 
| 10 | P00090217 | MEDICARE ID-TYPE UNSPECIFIED | NEW JERSEY | RAILROAD MEDICARE | 
| 11 | 0007295366 | OTHER | NEW JERSEY | AETNA PPO | 
| 12 | P2717905 | OTHER | NEW JERSEY | OXFORD | 
| 13 | 7007553 | OTHER | NEW JERSEY | CIGNA | 
| 14 | 3245799 | OTHER | NEW JERSEY | AETNA HMO | 
| 15 | 223522719 | OTHER | NEW JERSEY | HORIZON BCBS | 
| 16 | 2226084000 | OTHER | NEW JERSEY | AMERIHEALTH HMO | 
| 17 | 01000597300 | OTHER | NEW JERSEY | AMERICHOICE |