{
"Npi": {
"NPI": "1275149411",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "MCHALE",
"FirstName": "HOLLY",
"MiddleName": "CHRISTINE",
"NamePrefix": null,
"NameSuffix": null,
"Credential": "ATC",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "MENDENHALL",
"OtherFirstName": "HOLLY",
"OtherMiddleName": "CHRISTINE",
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": "ATC",
"OtherLastNameTypeCode": "5",
"FirstLineMailingAddress": "2417 JERICHO TPKE # 268",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "GARDEN CITY PARK",
"MailingAddressStateName": "NY",
"MailingAddressPostalCode": "11040-4710",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "631-662-6355",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "350 S SERVICE RD",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "MELVILLE",
"PracticeLocationAddressStateName": "NY",
"PracticeLocationAddressPostalCode": "11747-3233",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "631-662-6355",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "09/22/2020",
"LastUpdateDate": "09/22/2020",
"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": "2255A2300X",
"TaxonomyName": "Athletic Trainer",
"LicenseNumber": "003078",
"LicenseNumberStateCode": "NY",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}