{
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"FirstLineMailingAddress": "2310 KNAPP ST",
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"MailingAddressCityName": "BROOKLYN",
"MailingAddressStateName": "NY",
"MailingAddressPostalCode": "11229-5924",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "718-513-6178",
"MailingAddressFaxNumber": "718-513-6179",
"FirstLinePracticeLocationAddress": "9525 CHURCH AVE",
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"PracticeLocationAddressCityName": "BROOKLYN",
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"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "718-513-6178",
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"EnumerationDate": "02/27/2012",
"LastUpdateDate": "10/29/2024",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "SHABATAY",
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"AuthorizedOfficialTelephoneNumber": "718-513-6178",
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "333600000X",
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"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "3336C0003X",
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}
]
},
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}
}