1033656616 NPI number — WILLIAM J GALESE LIFEGUARD-E.M.T.

NPI Number: 1033656616
Health Care Provider/Practitioner: WILLIAM J GALESE LIFEGUARD-E.M.T.

NPI Number : 1033656616 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1033656616",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "GALESE",
    "FirstName": "WILLIAM",
    "MiddleName": "J",
    "NamePrefix": "MR.",
    "NameSuffix": null,
    "Credential": "LIFEGUARD-E.M.T.",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "15694 STATE ROUTE 193",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "MANNSVILLE",
    "MailingAddressStateName": "NY",
    "MailingAddressPostalCode": "13661",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "609-200-0480",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "1839 COUNTY RD 565",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "GLENWOOD",
    "PracticeLocationAddressStateName": "NJ",
    "PracticeLocationAddressPostalCode": "07418-1048",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "609-200-0480",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "01/20/2017",
    "LastUpdateDate": "07/05/2023",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "M",
    "Gender": "Male",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "376J00000X",
          "TaxonomyName": "Homemaker",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "376K00000X",
          "TaxonomyName": "Nurse's Aide",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "146L00000X",
          "TaxonomyName": "Paramedic",
          "LicenseNumber": null,
          "LicenseNumberStateCode": "NJ",
          "PrimaryTaxonomySwitch": "Y"
        },
        {
          "TaxonomyCode": "146N00000X",
          "TaxonomyName": "Basic Emergency Medical Technician",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "372600000X",
          "TaxonomyName": "Adult Companion",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "374U00000X",
          "TaxonomyName": "Home Health Aide",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}