{
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"OrgName": "SOUTH SHORE INTEGRATED PHYSICAL THERAPY, ACUPUNCTURE AND MASSAGE PLLC",
"LastName": null,
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"FirstLineMailingAddress": "718 LONG ISLAND AVE",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "DEER PARK",
"MailingAddressStateName": "NY",
"MailingAddressPostalCode": "11729-4230",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "631-242-1818",
"MailingAddressFaxNumber": "631-242-1506",
"FirstLinePracticeLocationAddress": "718 LONG ISLAND AVE",
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"PracticeLocationAddressCityName": "DEER PARK",
"PracticeLocationAddressStateName": "NY",
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"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "631-242-1818",
"PracticeLocationAddressFaxNumber": "631-242-1506",
"EnumerationDate": "06/13/2014",
"LastUpdateDate": "06/13/2014",
"NPIDeactivationReasonCode": null,
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"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "DINSAY",
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"AuthorizedOfficialCredential": "PT",
"AuthorizedOfficialTelephoneNumber": "516-770-3127",
"Taxonomies": {
"Taxonomy": {
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"TaxonomyName": "Physical Therapist",
"LicenseNumber": "022171",
"LicenseNumberStateCode": "NY",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
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}
}
}
}