{
"Npi": {
"NPI": "1033401211",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "GOOD SAMARITAN HOSPITAL",
"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": "1000 MONTAUK HIGHWAY",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "WEST ISLIP",
"MailingAddressStateName": "NY",
"MailingAddressPostalCode": "11795",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": null,
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "1000 MONTAUK HIGHWAY",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "WEST ISLIP",
"PracticeLocationAddressStateName": "NY",
"PracticeLocationAddressPostalCode": "11795",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "631-376-3069",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "05/06/2011",
"LastUpdateDate": "05/06/2011",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "JAQUAY",
"AuthorizedOfficialFirstName": "ELIZABETH",
"AuthorizedOfficialMiddleName": "MARION",
"AuthorizedOfficialTitle": "OCCUPATIONAL THERAPIST",
"AuthorizedOfficialNamePrefix": "MISS",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "MSOTR/L",
"AuthorizedOfficialTelephoneNumber": "631-376-3076",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QR0401X",
"TaxonomyName": "Comprehensive Outpatient Rehabilitation Facility (CORF)",
"LicenseNumber": "0160601",
"LicenseNumberStateCode": "NY",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}