{
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"FirstLineMailingAddress": "185 PENINSULA BLVD",
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"MailingAddressCityName": "HEMPSTEAD",
"MailingAddressStateName": "NY",
"MailingAddressPostalCode": "11550-4900",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "516-292-7111",
"MailingAddressFaxNumber": "516-292-3115",
"FirstLinePracticeLocationAddress": "185 PENINSULA BOULEVARD",
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"EnumerationDate": "03/07/2007",
"LastUpdateDate": "11/01/2017",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "DOBROFF",
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"AuthorizedOfficialTitle": "ASST. SUPT. FOR BUSINESS",
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"AuthorizedOfficialTelephoneNumber": "516-434-4061",
"Taxonomies": {
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"TaxonomyName": "Local Education Agency (LEA)",
"LicenseNumber": null,
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"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}