{
"Npi": {
"NPI": "1124796420",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "ADVANCED MEDICAL IMAGING PROFESSIONALS LLC",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "510 SYLVAN AVE",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "ENGLEWOOD CLIFFS",
"MailingAddressStateName": "NJ",
"MailingAddressPostalCode": "07632-3057",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "917-379-7141",
"MailingAddressFaxNumber": "732-837-4514",
"FirstLinePracticeLocationAddress": "510 SYLVAN AVE",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "ENGLEWOOD CLIFFS",
"PracticeLocationAddressStateName": "NJ",
"PracticeLocationAddressPostalCode": "07632-3057",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "917-379-7141",
"PracticeLocationAddressFaxNumber": "732-837-4514",
"EnumerationDate": "09/01/2021",
"LastUpdateDate": "03/01/2023",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "MIKABERIDZE",
"AuthorizedOfficialFirstName": "IRINA",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "PRESIDENT",
"AuthorizedOfficialNamePrefix": "MRS.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "201-227-1200",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QR0200X",
"TaxonomyName": "Radiology Clinic/Center",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}