{
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"FirstLineMailingAddress": "121 EVERETT RD",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "ALBANY",
"MailingAddressStateName": "NY",
"MailingAddressPostalCode": "12205-1474",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "518-489-2663",
"MailingAddressFaxNumber": "518-689-3881",
"FirstLinePracticeLocationAddress": "123 EVERETT RD",
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"PracticeLocationAddressCityName": "ALBANY",
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"PracticeLocationAddressTelephoneNumber": "518-489-2663",
"PracticeLocationAddressFaxNumber": "518-689-3881",
"EnumerationDate": "06/24/2019",
"LastUpdateDate": "07/23/2025",
"NPIDeactivationReasonCode": null,
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"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "CONGIUSTA",
"AuthorizedOfficialFirstName": "FRANK",
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"AuthorizedOfficialCredential": "MD",
"AuthorizedOfficialTelephoneNumber": "518-453-9088",
"Taxonomies": {
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"TaxonomyName": "Ambulatory Surgical Clinic/Center",
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"PrimaryTaxonomySwitch": "Y"
}
},
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}
}