{
"Npi": {
"NPI": "1083859854",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "EXECUTIVE WOODS SLEEP DISORDER CTR LLC",
"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": "5 PALISADES DRIVE",
"SecondLineMailingAddress": "SUITE 100",
"MailingAddressCityName": "ALBANY",
"MailingAddressStateName": "NY",
"MailingAddressPostalCode": "12205-6433",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "518-438-4496",
"MailingAddressFaxNumber": "518-438-5803",
"FirstLinePracticeLocationAddress": "5 PALISADES DRIVE",
"SecondLinePracticeLocationAddress": "SUITE 100",
"PracticeLocationAddressCityName": "ALBANY",
"PracticeLocationAddressStateName": "NY",
"PracticeLocationAddressPostalCode": "12205-6433",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "518-438-4496",
"PracticeLocationAddressFaxNumber": "518-438-5803",
"EnumerationDate": "12/09/2008",
"LastUpdateDate": "12/09/2008",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "MURPHY",
"AuthorizedOfficialFirstName": "WILLIAM",
"AuthorizedOfficialMiddleName": "J",
"AuthorizedOfficialTitle": "PRACTICE ADMINISTRATOR",
"AuthorizedOfficialNamePrefix": "MR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "518-272-0331",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QS1200X",
"TaxonomyName": "Sleep Disorder Diagnostic Clinic/Center",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}