{
"Npi": {
"NPI": "1154188209",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "SHUKLA",
"FirstName": "TOESHA",
"MiddleName": "MANISHKUMAR",
"NamePrefix": null,
"NameSuffix": null,
"Credential": "PHYSICAL THERAPIST",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "7002 JFK BOULEVARD EAST",
"SecondLineMailingAddress": "APT #43 D",
"MailingAddressCityName": "GUTTENBERG",
"MailingAddressStateName": "NJ",
"MailingAddressPostalCode": "07093",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "917-913-6007",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "138TH ST BRONX",
"SecondLinePracticeLocationAddress": "255 EAST",
"PracticeLocationAddressCityName": "NEW YORK",
"PracticeLocationAddressStateName": "NY",
"PracticeLocationAddressPostalCode": "10451",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "718-559-0909",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "03/05/2024",
"LastUpdateDate": "03/05/2024",
"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": "225100000X",
"TaxonomyName": "Physical Therapist",
"LicenseNumber": "051643-01",
"LicenseNumberStateCode": "NY",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}