{
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"FirstLineMailingAddress": "44 LEATHERWOOD PL APT F",
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"MailingAddressCountryCode": "US",
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"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "1 HIGHHAVEN PL APT TB",
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"EnumerationDate": "11/27/2024",
"LastUpdateDate": "12/25/2024",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "REHMAN",
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"AuthorizedOfficialTelephoneNumber": "516-225-3473",
"Taxonomies": {
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"LicenseNumber": null,
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"PrimaryTaxonomySwitch": "Y"
}
},
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}
}