{
"Npi": {
"NPI": "1104906015",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "Y",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "KALLUS",
"FirstName": "TAMAR",
"MiddleName": "RUTH",
"NamePrefix": "DR.",
"NameSuffix": null,
"Credential": "OD",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "335 MAPLE ST",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "ENGLEWOOD",
"MailingAddressStateName": "NJ",
"MailingAddressPostalCode": "07631-3705",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "201-837-2061",
"MailingAddressFaxNumber": "201-837-2061",
"FirstLinePracticeLocationAddress": "106 FERRY ST",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "NEWARK",
"PracticeLocationAddressStateName": "NJ",
"PracticeLocationAddressPostalCode": "07105-2106",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "973-589-8085",
"PracticeLocationAddressFaxNumber": "973-589-2891",
"EnumerationDate": "10/16/2006",
"LastUpdateDate": "07/08/2007",
"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": "152W00000X",
"TaxonomyName": "Optometrist",
"LicenseNumber": "OA 005755",
"LicenseNumberStateCode": "NJ",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}