{
"Npi": {
"NPI": "1235264052",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "CRICOR HOLDINGS, INC.",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": "6",
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "4202 GREENPOINT AVE",
"SecondLineMailingAddress": "B",
"MailingAddressCityName": "SUNNYSIDE",
"MailingAddressStateName": "NY",
"MailingAddressPostalCode": "11104-3004",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "718-433-3091",
"MailingAddressFaxNumber": "718-433-1657",
"FirstLinePracticeLocationAddress": "4202 GREENPOINT AVE",
"SecondLinePracticeLocationAddress": "B",
"PracticeLocationAddressCityName": "SUNNYSIDE",
"PracticeLocationAddressStateName": "NY",
"PracticeLocationAddressPostalCode": "11104-3004",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "718-433-3091",
"PracticeLocationAddressFaxNumber": "718-433-1657",
"EnumerationDate": "02/22/2007",
"LastUpdateDate": "03/26/2008",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "DOLMAIAN",
"AuthorizedOfficialFirstName": "SIMON",
"AuthorizedOfficialMiddleName": "CRICOR",
"AuthorizedOfficialTitle": "SUPERVISING PHARMACIST",
"AuthorizedOfficialNamePrefix": "MR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "RPH",
"AuthorizedOfficialTelephoneNumber": "718-433-3091",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "3336C0003X",
"TaxonomyName": "Community/Retail Pharmacy",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}