{
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"FirstLineMailingAddress": "2614 BOSTON POST RD",
"SecondLineMailingAddress": "SUITE 16C",
"MailingAddressCityName": "GUILFORD",
"MailingAddressStateName": "CT",
"MailingAddressPostalCode": "06437-1369",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "203-689-5295",
"MailingAddressFaxNumber": "203-689-5428",
"FirstLinePracticeLocationAddress": "2614 BOSTON POST RD",
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"EnumerationDate": "08/06/2009",
"LastUpdateDate": "02/22/2012",
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"NPIReactivationDate": null,
"GenderCode": null,
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"AuthorizedOfficialLastName": "COLLINS",
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"AuthorizedOfficialCredential": "M.D.",
"AuthorizedOfficialTelephoneNumber": "404-374-2654",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "2086S0122X",
"TaxonomyName": "Plastic and Reconstructive Surgery Physician",
"LicenseNumber": "047848",
"LicenseNumberStateCode": "CT",
"PrimaryTaxonomySwitch": "Y"
}
},
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}
}
}
}