{
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"FirstLineMailingAddress": "133 JANWICH DR",
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"MailingAddressCountryCode": "US",
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"FirstLinePracticeLocationAddress": "625 HAMBURG TPKE UNIT 14",
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"EnumerationDate": "12/29/2025",
"LastUpdateDate": "12/29/2025",
"NPIDeactivationReasonCode": null,
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"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "HENKIN",
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"AuthorizedOfficialTelephoneNumber": "732-822-7313",
"Taxonomies": {
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"PrimaryTaxonomySwitch": "Y"
}
},
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}
}