{
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"NPI": "1003004037",
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"EIN": null,
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"IsOrgSubpart": "N",
"ParentOrgLBN": null,
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"OrgName": "NORTHWEST NEW JERSEY URGENT CARE ALLIANCE PC",
"LastName": null,
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"NamePrefix": null,
"NameSuffix": null,
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"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "175 HIGH ST",
"SecondLineMailingAddress": "FINANCE DEPARTMENT",
"MailingAddressCityName": "NEWTON",
"MailingAddressStateName": "NJ",
"MailingAddressPostalCode": "07860-1004",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "973-579-8999",
"MailingAddressFaxNumber": "973-579-8676",
"FirstLinePracticeLocationAddress": "212 ROUTE 94",
"SecondLinePracticeLocationAddress": "SUITE 1A",
"PracticeLocationAddressCityName": "VERNON",
"PracticeLocationAddressStateName": "NJ",
"PracticeLocationAddressPostalCode": "07462-3328",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "973-209-2260",
"PracticeLocationAddressFaxNumber": "973-209-1895",
"EnumerationDate": "10/03/2007",
"LastUpdateDate": "10/03/2007",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "DILLON",
"AuthorizedOfficialFirstName": "BRUCE",
"AuthorizedOfficialMiddleName": "PATRICK",
"AuthorizedOfficialTitle": "DIRECTOR",
"AuthorizedOfficialNamePrefix": "MR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "973-579-8999",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QU0200X",
"TaxonomyName": "Urgent Care Clinic/Center",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}