{
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"EIN": null,
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"IsOrgSubpart": "N",
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"OrgName": "LYNN P HILLERY/LIVE WELL WITH LYNN",
"LastName": null,
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"FirstLineMailingAddress": "25 ANDREA LN",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "WEST SAYVILLE",
"MailingAddressStateName": "NY",
"MailingAddressPostalCode": "11796-1515",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": null,
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "76 SOUTHAVEN AVE",
"SecondLinePracticeLocationAddress": "STE 2",
"PracticeLocationAddressCityName": "MEDFORD",
"PracticeLocationAddressStateName": "NY",
"PracticeLocationAddressPostalCode": "11763-3745",
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"PracticeLocationAddressTelephoneNumber": "631-343-2024",
"PracticeLocationAddressFaxNumber": "631-343-2024",
"EnumerationDate": "06/07/2010",
"LastUpdateDate": "06/07/2010",
"NPIDeactivationReasonCode": null,
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"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "HILLERY",
"AuthorizedOfficialFirstName": "LYNN",
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"AuthorizedOfficialCredential": "RD",
"AuthorizedOfficialTelephoneNumber": "631-921-1100",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "133V00000X",
"TaxonomyName": "Registered Dietitian",
"LicenseNumber": "006087-1",
"LicenseNumberStateCode": "NY",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
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"HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
}
}
}
}