{
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"EIN": null,
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"OrgName": "MICHAEL AHDOOT, MD, PC",
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"FirstLineMailingAddress": "PO BOX 231297",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "GREAT NECK",
"MailingAddressStateName": "NY",
"MailingAddressPostalCode": "11023-0297",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "516-672-3030",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "4601 QUEENS BLVD",
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"PracticeLocationAddressCityName": "SUNNYSIDE",
"PracticeLocationAddressStateName": "NY",
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"PracticeLocationAddressTelephoneNumber": "718-565-2020",
"PracticeLocationAddressFaxNumber": "718-565-2052",
"EnumerationDate": "02/27/2008",
"LastUpdateDate": "03/20/2019",
"NPIDeactivationReasonCode": null,
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"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "AHDOOT",
"AuthorizedOfficialFirstName": "MICHAEL",
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"AuthorizedOfficialTitle": "PRESIDENT",
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"AuthorizedOfficialCredential": "M.D.",
"AuthorizedOfficialTelephoneNumber": "516-672-3030",
"Taxonomies": {
"Taxonomy": {
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"TaxonomyName": "Ophthalmology Physician",
"LicenseNumber": "230961",
"LicenseNumberStateCode": "NY",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"HealthcareProviderTaxonomyGroupName": "193400000X SINGLE SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
}
}
}
}