{
"Npi": {
"NPI": "1255774766",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "Y",
"ParentOrgLBN": "DR. JM DA SILVA PSYCHOLOGIST PC",
"ParentOrgTIN": null,
"OrgName": "DR. JM DA SILVA PSYCHOLOGIST PC",
"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": "68 LAIGHT ST APT 7",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "NEW YORK",
"MailingAddressStateName": "NY",
"MailingAddressPostalCode": "10013-2049",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "917-903-5067",
"MailingAddressFaxNumber": "212-226-7380",
"FirstLinePracticeLocationAddress": "68 LAIGHT ST APT 7",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "NEW YORK",
"PracticeLocationAddressStateName": "NY",
"PracticeLocationAddressPostalCode": "10013-2049",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "917-903-5067",
"PracticeLocationAddressFaxNumber": "212-226-7380",
"EnumerationDate": "04/15/2013",
"LastUpdateDate": "04/15/2013",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "DA SILVA",
"AuthorizedOfficialFirstName": "JURACI",
"AuthorizedOfficialMiddleName": "M.",
"AuthorizedOfficialTitle": "PSYCHOLOGIST",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "PH.D",
"AuthorizedOfficialTelephoneNumber": "917-903-5067",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QH0100X",
"TaxonomyName": "Health Service Clinic/Center",
"LicenseNumber": "018633-1",
"LicenseNumberStateCode": "NY",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}