{
"Npi": {
"NPI": "1154583748",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "BOUTAEVA",
"FirstName": "ZINAIDA",
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": "M.D.",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "6232 AVALON DR W",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "ORANGE",
"MailingAddressStateName": "CT",
"MailingAddressPostalCode": "06477-3679",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "203-908-3138",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "6232 AVALON DR W",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "ORANGE",
"PracticeLocationAddressStateName": "CT",
"PracticeLocationAddressPostalCode": "06477-3679",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "203-908-3138",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "06/25/2008",
"LastUpdateDate": "06/25/2008",
"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": "2084P0802X",
"TaxonomyName": "Addiction Psychiatry Physician",
"LicenseNumber": "046350",
"LicenseNumberStateCode": "CT",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}