{
"Npi": {
"NPI": "1134373327",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "FARESICH PARTNER PROCESS, 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": "4 MEADOW LARK CT",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "RANDOLPH",
"MailingAddressStateName": "NJ",
"MailingAddressPostalCode": "07869-2128",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "973-361-8113",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "311 SOUTH LIVINGSTON AVENUE",
"SecondLinePracticeLocationAddress": "INGLEMOOR REHABILITATION AND CARE CENTER",
"PracticeLocationAddressCityName": "LIVINGSTON",
"PracticeLocationAddressStateName": "NJ",
"PracticeLocationAddressPostalCode": "07039",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "973-994-0221",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "11/14/2008",
"LastUpdateDate": "04/16/2009",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "FARESICH",
"AuthorizedOfficialFirstName": "BARBARA",
"AuthorizedOfficialMiddleName": "K",
"AuthorizedOfficialTitle": "MANAGING MEMBER",
"AuthorizedOfficialNamePrefix": "MRS.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "APNC",
"AuthorizedOfficialTelephoneNumber": "973-219-7800",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "363LA2200X",
"TaxonomyName": "Adult Health Nurse Practitioner",
"LicenseNumber": "26NN08294900",
"LicenseNumberStateCode": "NJ",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"HealthcareProviderTaxonomyGroupName": "193400000X SINGLE SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
}
}
}
}