{
"Npi": {
"NPI": "1013221498",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "MISERICORDIA UNIVERSITY SPEECH-LANGUAGE AND HEARING CENTER",
"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": "301 LAKE ST",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "DALLAS",
"MailingAddressStateName": "PA",
"MailingAddressPostalCode": "18612-1008",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "570-674-8050",
"MailingAddressFaxNumber": "570-255-3375",
"FirstLinePracticeLocationAddress": "301 LAKE ST",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "DALLAS",
"PracticeLocationAddressStateName": "PA",
"PracticeLocationAddressPostalCode": "18612-1008",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "570-674-8050",
"PracticeLocationAddressFaxNumber": "570-255-3375",
"EnumerationDate": "07/28/2010",
"LastUpdateDate": "07/28/2010",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "RISBOSKIN",
"AuthorizedOfficialFirstName": "JOHN",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "VISE PRESIDENT FINANCE AND ADMINIST",
"AuthorizedOfficialNamePrefix": "MR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "570-674-6324",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "252Y00000X",
"TaxonomyName": "Early Intervention Provider Agency",
"LicenseNumber": "SL003615L",
"LicenseNumberStateCode": "PA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}