{
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"OrgName": "DHIRENDRA S BANA, MD, PC",
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"FirstLineMailingAddress": "1153 CENTRE ST STE 5935",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "JAMAICA PLAIN",
"MailingAddressStateName": "MA",
"MailingAddressPostalCode": "02130-3446",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "617-524-3700",
"MailingAddressFaxNumber": "617-524-5839",
"FirstLinePracticeLocationAddress": "1153 CENTRE ST STE 5935",
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"PracticeLocationAddressCityName": "JAMAICA PLAIN",
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"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "617-524-3700",
"PracticeLocationAddressFaxNumber": "617-524-5839",
"EnumerationDate": "04/22/2008",
"LastUpdateDate": "04/22/2008",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "BANA",
"AuthorizedOfficialFirstName": "DHIRENDRA",
"AuthorizedOfficialMiddleName": "SINGH",
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"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "MD",
"AuthorizedOfficialTelephoneNumber": "617-524-3700",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "207R00000X",
"TaxonomyName": "Internal Medicine Physician",
"LicenseNumber": "035706",
"LicenseNumberStateCode": "MA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
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"HealthcareProviderTaxonomyGroupName": "193400000X MULTIPLE 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."
}
}
}
}