{
"Npi": {
"NPI": "1013200260",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "MANHATTAN AVENUE HEARING AIDS, INC",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "15 BRAMSHOTT CT",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "ROCKVILLE CENTRE",
"MailingAddressStateName": "NY",
"MailingAddressPostalCode": "11570-1860",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "917-856-2703",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "934 MANHATTAN AVE",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "BROOKLYN",
"PracticeLocationAddressStateName": "NY",
"PracticeLocationAddressPostalCode": "11222-5928",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "917-856-2703",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "05/20/2011",
"LastUpdateDate": "02/08/2018",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "VILLANUEVA",
"AuthorizedOfficialFirstName": "CLARE",
"AuthorizedOfficialMiddleName": "M",
"AuthorizedOfficialTitle": "PRESIDENT",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "AUD",
"AuthorizedOfficialTelephoneNumber": "917-856-2703",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QH0700X",
"TaxonomyName": "Hearing and Speech Clinic/Center",
"LicenseNumber": "1764-1",
"LicenseNumberStateCode": "NY",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}