{
"Npi": {
"NPI": "1174039663",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "MARGA PHARMACY 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": "33 W BURNSIDE AVE",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "BRONX",
"MailingAddressStateName": "NY",
"MailingAddressPostalCode": "10453-4020",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "718-618-7676",
"MailingAddressFaxNumber": "718-618-7776",
"FirstLinePracticeLocationAddress": "33 W BURNSIDE AVE",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "BRONX",
"PracticeLocationAddressStateName": "NY",
"PracticeLocationAddressPostalCode": "10453-4020",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "718-618-7676",
"PracticeLocationAddressFaxNumber": "718-618-7776",
"EnumerationDate": "12/19/2017",
"LastUpdateDate": "12/11/2022",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "TORIBIO",
"AuthorizedOfficialFirstName": "LIDAMI",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "OWNER",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "COLLEGE GRADUATE",
"AuthorizedOfficialTelephoneNumber": "718-618-7676",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "3336C0003X",
"TaxonomyName": "Community/Retail Pharmacy",
"LicenseNumber": "035957",
"LicenseNumberStateCode": "NY",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}