{
"Npi": {
"NPI": "1033512256",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "MIRIAM SIMON, 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": "878 LONGACRE AVE",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "VALLEY STREAM",
"MailingAddressStateName": "NY",
"MailingAddressPostalCode": "11581-3510",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "917-687-1931",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "878 LONGACRE AVE",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "VALLEY STREAM",
"PracticeLocationAddressStateName": "NY",
"PracticeLocationAddressPostalCode": "11581-3510",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "917-687-1931",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "10/01/2014",
"LastUpdateDate": "10/01/2014",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "SIMON",
"AuthorizedOfficialFirstName": "MIRIAM",
"AuthorizedOfficialMiddleName": "BRYNA",
"AuthorizedOfficialTitle": "THERAPIST",
"AuthorizedOfficialNamePrefix": "MISS",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "LCSW",
"AuthorizedOfficialTelephoneNumber": "917-687-1931",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261Q00000X",
"TaxonomyName": "Clinic/Center",
"LicenseNumber": "076796-1",
"LicenseNumberStateCode": "NY",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}