{
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"EIN": null,
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"IsOrgSubpart": "N",
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"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
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"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "245 MAIN ST",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "WAKEFIELD",
"MailingAddressStateName": "RI",
"MailingAddressPostalCode": "02879-3527",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "401-360-3200",
"MailingAddressFaxNumber": "401-783-0045",
"FirstLinePracticeLocationAddress": "245 MAIN ST",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "WAKEFIELD",
"PracticeLocationAddressStateName": "RI",
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"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "401-360-3300",
"PracticeLocationAddressFaxNumber": "401-783-0045",
"EnumerationDate": "12/11/2015",
"LastUpdateDate": "09/10/2021",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "PROCACCIANTI",
"AuthorizedOfficialFirstName": "CHRISTINA",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "OWNER, PIC, AO",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "PHARMD",
"AuthorizedOfficialTelephoneNumber": "401-360-3200",
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "333600000X",
"TaxonomyName": "Pharmacy",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "3336C0003X",
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}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}