{
"Npi": {
"NPI": "1083867642",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "MARGUERITE M. MIKULSKI",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": "6",
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "25 LIBERTY ST",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "BATAVIA",
"MailingAddressStateName": "NY",
"MailingAddressPostalCode": "14020-3246",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "585-343-1840",
"MailingAddressFaxNumber": "585-343-2185",
"FirstLinePracticeLocationAddress": "25 LIBERTY ST",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "BATAVIA",
"PracticeLocationAddressStateName": "NY",
"PracticeLocationAddressPostalCode": "14020-3246",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "585-343-1840",
"PracticeLocationAddressFaxNumber": "585-343-2185",
"EnumerationDate": "10/28/2008",
"LastUpdateDate": "10/28/2008",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "MIKULSKI",
"AuthorizedOfficialFirstName": "MARGUERITE",
"AuthorizedOfficialMiddleName": "MARY",
"AuthorizedOfficialTitle": "PROPRIETOR",
"AuthorizedOfficialNamePrefix": "MRS.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "OTR",
"AuthorizedOfficialTelephoneNumber": "585-343-1840",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "252Y00000X",
"TaxonomyName": "Early Intervention Provider Agency",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}