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 | 207RC0000X | Internal Medicine | Cardiovascular Disease | | NEW YORK | No |
| 2 | 207K00000X | Allergy & Immunology | | | NEW YORK | No |
| 3 | 207P00000X | Emergency Medicine | | | NEW YORK | No |
| 4 | 207Q00000X | Family Medicine | | | NEW YORK | No |
| 5 | 207R00000X | Internal Medicine | | | NEW YORK | No |
| 6 | 207RC0001X | Internal Medicine | Clinical Cardiac Electrophysiology | | NEW YORK | No |
| 7 | 207RC0200X | Internal Medicine | Critical Care Medicine | | NEW YORK | No |
| 8 | 207RE0101X | Internal Medicine | Endocrinology, Diabetes & Metabolism | | NEW YORK | No |
| 9 | 207RG0100X | Internal Medicine | Gastroenterology | | NEW YORK | No |
| 10 | 207RG0300X | Internal Medicine | Geriatric Medicine | | NEW YORK | No |
| 11 | 207RH0003X | Internal Medicine | Hematology & Oncology | | NEW YORK | No |
| 12 | 207RI0011X | Internal Medicine | Interventional Cardiology | | NEW YORK | No |
| 13 | 207RI0200X | Internal Medicine | Infectious Disease | | NEW YORK | No |
| 14 | 207RM1200X | Internal Medicine | Magnetic Resonance Imaging (MRI) | | NEW YORK | No |
| 15 | 208D00000X | General Practice | | | 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 | 02409709 | MEDICAID | NEW YORK | |
