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1124231543 NPI number — LYUBOV NIKOLAEVNA ODES PA

NPI Number: 1124231543
Health Care Provider/Practitioner: LYUBOV NIKOLAEVNA ODES PA

Information about “1124231543” NPI (LYUBOV NIKOLAEVNA ODES PA) exists in 1124231543 in HTML format HTML  |  1124231543 in plain Text format TXT  |  1124231543 in PDF (Portable Document Format) PDF  |  1124231543 in an XML format XML  formats.

NPI Number : 1124231543 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1124231543",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "ODES",
    "FirstName": "LYUBOV",
    "MiddleName": "NIKOLAEVNA",
    "NamePrefix": "MS.",
    "NameSuffix": null,
    "Credential": "PA",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "ODES",
    "OtherFirstName": "LYUBOV",
    "OtherMiddleName": "NIKOLAEVNA",
    "OtherNamePrefix": "MS.",
    "OtherNameSuffix": null,
    "OtherCredential": "PA",
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "440 EAST 9TH STREET",
    "SecondLineMailingAddress": "APT 6 E",
    "MailingAddressCityName": "BROOKLYN",
    "MailingAddressStateName": "NY",
    "MailingAddressPostalCode": "11218",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "718-284-0406",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "440 EAST 9TH STREET",
    "SecondLinePracticeLocationAddress": "APT 6 E",
    "PracticeLocationAddressCityName": "BROOKLYN",
    "PracticeLocationAddressStateName": "NY",
    "PracticeLocationAddressPostalCode": "11218",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "718-284-0406",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "05/08/2007",
    "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": "363A00000X",
        "TaxonomyName": "Physician Assistant",
        "LicenseNumber": "009144",
        "LicenseNumberStateCode": "NY",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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