{
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"OrgName": "FIT TO FUNCTION OCCUPATIONAL THERAPY SERVICES PLLC",
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"FirstLineMailingAddress": "11 CAPRI CT",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "DIX HILLS",
"MailingAddressStateName": "NY",
"MailingAddressPostalCode": "11746-6400",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "631-355-0882",
"MailingAddressFaxNumber": "866-850-4553",
"FirstLinePracticeLocationAddress": "256 W OLD COUNTRY RD UNIT A",
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"PracticeLocationAddressCityName": "HICKSVILLE",
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"PracticeLocationAddressFaxNumber": "866-850-4553",
"EnumerationDate": "07/19/2017",
"LastUpdateDate": "07/19/2017",
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"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "AHUJA",
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"AuthorizedOfficialTitle": "OWNER/ OCCUPATIONAL THERAPIST",
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"AuthorizedOfficialCredential": "OTR",
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"Taxonomies": {
"Taxonomy": {
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"TaxonomyName": "Occupational Therapist",
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"LicenseNumberStateCode": "NY",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
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}
}
}
}