{
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"FirstLineMailingAddress": "2621 BROWN ST",
"SecondLineMailingAddress": "#1",
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"PracticeLocationAddressFaxNumber": "718-421-9073",
"EnumerationDate": "07/06/2011",
"LastUpdateDate": "07/06/2011",
"NPIDeactivationReasonCode": null,
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"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "KRUPNOVA",
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"AuthorizedOfficialCredential": "LICENSED AC",
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"Taxonomies": {
"Taxonomy": {
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"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
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}
}
}
}