{
"Npi": {
"NPI": "1225357866",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "Y",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "OIESTAD",
"FirstName": "DENISE",
"MiddleName": null,
"NamePrefix": "MRS.",
"NameSuffix": null,
"Credential": "P.T.",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "DITO",
"OtherFirstName": "DENISE",
"OtherMiddleName": "OIESTAD",
"OtherNamePrefix": "MRS.",
"OtherNameSuffix": null,
"OtherCredential": "P.T.",
"OtherLastNameTypeCode": "5",
"FirstLineMailingAddress": "519 BROADWAY",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "STATEN ISLAND",
"MailingAddressStateName": "NY",
"MailingAddressPostalCode": "10310-2845",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "718-442-4878",
"MailingAddressFaxNumber": "718-442-4878",
"FirstLinePracticeLocationAddress": "519 BROADWAY",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "STATEN ISLAND",
"PracticeLocationAddressStateName": "NY",
"PracticeLocationAddressPostalCode": "10310-2845",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "718-442-4878",
"PracticeLocationAddressFaxNumber": "718-442-4878",
"EnumerationDate": "05/21/2010",
"LastUpdateDate": "05/21/2010",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": "F",
"Gender": "Female",
"AuthorizedOfficialLastName": null,
"AuthorizedOfficialFirstName": null,
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": null,
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": null,
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "2251P0200X",
"TaxonomyName": "Pediatric Physical Therapist",
"LicenseNumber": "013937-1",
"LicenseNumberStateCode": "NY",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}