{
"Npi": {
"NPI": "1154528180",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "A-1 SURGICAL AND MEDICAL SUPPLIES INC",
"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": "30 E JEFFERSON AVE",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "MINEOLA",
"MailingAddressStateName": "NY",
"MailingAddressPostalCode": "11501-3123",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "516-741-1087",
"MailingAddressFaxNumber": "516-873-7904",
"FirstLinePracticeLocationAddress": "54 MAIN ST",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "HEMPSTEAD",
"PracticeLocationAddressStateName": "NY",
"PracticeLocationAddressPostalCode": "11550-4051",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "516-292-4105",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "07/02/2007",
"LastUpdateDate": "04/22/2009",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "CORSENTINO",
"AuthorizedOfficialFirstName": "ANTHONY",
"AuthorizedOfficialMiddleName": "P",
"AuthorizedOfficialTitle": "PRESIDENT/ORTHOTIST",
"AuthorizedOfficialNamePrefix": "MR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "BOARD CERTIFIED ORTH",
"AuthorizedOfficialTelephoneNumber": "516-292-4105",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "174400000X",
"TaxonomyName": "Specialist",
"LicenseNumber": "222Z00000X",
"LicenseNumberStateCode": "NY",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"HealthcareProviderTaxonomyGroupName": "193400000X MULTIPLE 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."
}
}
}
}