{
"Npi": {
"NPI": "1265559199",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "Y",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "FULGER",
"FirstName": "ILMANA",
"MiddleName": null,
"NamePrefix": "DR.",
"NameSuffix": null,
"Credential": "MD",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "KORNBLUM",
"OtherFirstName": "ILMANA",
"OtherMiddleName": null,
"OtherNamePrefix": "DR.",
"OtherNameSuffix": null,
"OtherCredential": "MD",
"OtherLastNameTypeCode": "5",
"FirstLineMailingAddress": "243 PARK HILL AVE",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "YONKERS",
"MailingAddressStateName": "NY",
"MailingAddressPostalCode": "10705-1436",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "914-423-2029",
"MailingAddressFaxNumber": "914-423-2029",
"FirstLinePracticeLocationAddress": "4487 3RD AVE",
"SecondLinePracticeLocationAddress": "FOURTH FLOOR CANCER CENTER",
"PracticeLocationAddressCityName": "BRONX",
"PracticeLocationAddressStateName": "NY",
"PracticeLocationAddressPostalCode": "10457-1526",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "718-960-6377",
"PracticeLocationAddressFaxNumber": "718-960-5522",
"EnumerationDate": "03/24/2007",
"LastUpdateDate": "07/24/2008",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": "F",
"Gender": "Female",
"AuthorizedOfficialLastName": null,
"AuthorizedOfficialFirstName": null,
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": null,
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": null,
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "207RH0003X",
"TaxonomyName": "Hematology & Oncology Physician",
"LicenseNumber": "243615",
"LicenseNumberStateCode": "NY",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}