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1043854193 NPI number — PAGE SOPHIA MCINTYRE

NPI Number: 1043854193
Health Care Provider/Practitioner: PAGE SOPHIA MCINTYRE

Information about “1043854193” NPI (PAGE SOPHIA MCINTYRE) exists in 1043854193 in HTML format HTML  |  1043854193 in plain Text format TXT  |  1043854193 in PDF (Portable Document Format) PDF  |  1043854193 in an XML format XML  formats.

NPI Number : 1043854193 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1043854193",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "MCINTYRE",
    "FirstName": "PAGE",
    "MiddleName": "SOPHIA",
    "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": "253 POWERS STREET, APT 3RR",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "BROOKLYN",
    "MailingAddressStateName": "NY",
    "MailingAddressPostalCode": "11211-0051",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "845-519-0997",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "935 S LAKE BLVD STE 2",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "MAHOPAC",
    "PracticeLocationAddressStateName": "NY",
    "PracticeLocationAddressPostalCode": "10541-3222",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "845-628-9284",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "11/01/2019",
    "LastUpdateDate": "02/05/2024",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "101YM0800X",
          "TaxonomyName": "Mental Health Counselor",
          "LicenseNumber": "P103310",
          "LicenseNumberStateCode": "NY",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "101YM0800X",
          "TaxonomyName": "Mental Health Counselor",
          "LicenseNumber": "103310-01",
          "LicenseNumberStateCode": "NY",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "101YM0800X",
          "TaxonomyName": "Mental Health Counselor",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "225A00000X",
          "TaxonomyName": "Music Therapist",
          "LicenseNumber": "104760-01",
          "LicenseNumberStateCode": "NY",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "101YM0800X",
          "TaxonomyName": "Mental Health Counselor",
          "LicenseNumber": "011775",
          "LicenseNumberStateCode": "NY",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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