{
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"FirstLineMailingAddress": "485 NEW PARK AVE STE F3",
"SecondLineMailingAddress": null,
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"MailingAddressCountryCode": "US",
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"MailingAddressFaxNumber": "860-216-4197",
"FirstLinePracticeLocationAddress": "485 NEW PARK AVE STE F3",
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"PracticeLocationAddressCityName": "WEST HARTFORD",
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"PracticeLocationAddressFaxNumber": "860-216-4197",
"EnumerationDate": "09/17/2015",
"LastUpdateDate": "09/17/2015",
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"NPIReactivationDate": null,
"GenderCode": null,
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"AuthorizedOfficialLastName": "MACDONALD",
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"AuthorizedOfficialTelephoneNumber": "860-904-6653",
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"PrimaryTaxonomySwitch": "Y"
}
},
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}
}