{
"Npi": {
"NPI": "1265693188",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "SOHO OPTICAL LLC",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "1720 MARLTON PIKE E",
"SecondLineMailingAddress": "SOHO OPTICAL",
"MailingAddressCityName": "CHERRY HILL",
"MailingAddressStateName": "NJ",
"MailingAddressPostalCode": "08003-2301",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "856-874-0011",
"MailingAddressFaxNumber": "856-874-0015",
"FirstLinePracticeLocationAddress": "1720 MARLTON PIKE E",
"SecondLinePracticeLocationAddress": "SOHO OPTICAL",
"PracticeLocationAddressCityName": "CHERRY HILL",
"PracticeLocationAddressStateName": "NJ",
"PracticeLocationAddressPostalCode": "08003-2301",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "856-874-0011",
"PracticeLocationAddressFaxNumber": "856-874-0015",
"EnumerationDate": "06/23/2008",
"LastUpdateDate": "09/18/2012",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "HONG",
"AuthorizedOfficialFirstName": "NARAH",
"AuthorizedOfficialMiddleName": "K",
"AuthorizedOfficialTitle": "OPTOMETRIST",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "OD",
"AuthorizedOfficialTelephoneNumber": "856-874-0011",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "152W00000X",
"TaxonomyName": "Optometrist",
"LicenseNumber": "27OA00590600",
"LicenseNumberStateCode": "NJ",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"HealthcareProviderTaxonomyGroupName": "193400000X SINGLE SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
}
}
}
}