{
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"IsOrgSubpart": "N",
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"OrgName": "SENECA PHYSICAL THERAPY OF THE FINGER LAKES, PC",
"LastName": null,
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"MiddleName": null,
"NamePrefix": null,
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"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "609 N FRANKLIN ST",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "WATKINS GLEN",
"MailingAddressStateName": "NY",
"MailingAddressPostalCode": "14891-1302",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "607-535-7475",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "609 N FRANKLIN ST",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "WATKINS GLEN",
"PracticeLocationAddressStateName": "NY",
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"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "607-535-7475",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "01/09/2007",
"LastUpdateDate": "08/22/2020",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "SMITH-SOCARIS",
"AuthorizedOfficialFirstName": "AMANDA",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "OWNER",
"AuthorizedOfficialNamePrefix": "MS.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "PT, MS, OCS, CSCS",
"AuthorizedOfficialTelephoneNumber": "607-535-7475",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "225100000X",
"TaxonomyName": "Physical Therapist",
"LicenseNumber": "018951-1",
"LicenseNumberStateCode": "NY",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"HealthcareProviderTaxonomyGroupName": "193400000X 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."
}
}
}
}