{
"Npi": {
"NPI": "1295735181",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "Y",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "RELOJ",
"FirstName": "NOEL",
"MiddleName": "Z",
"NamePrefix": "DR.",
"NameSuffix": "SR.",
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "PO BOX 2009",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "ELIZABETHTOWN",
"MailingAddressStateName": "KY",
"MailingAddressPostalCode": "42702-2009",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "270-769-6330",
"MailingAddressFaxNumber": "270-766-1032",
"FirstLinePracticeLocationAddress": "551 WESTPORT RD",
"SecondLinePracticeLocationAddress": "STE C",
"PracticeLocationAddressCityName": "ELIZABETHTOWN",
"PracticeLocationAddressStateName": "KY",
"PracticeLocationAddressPostalCode": "42701",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "270-769-6330",
"PracticeLocationAddressFaxNumber": "270-766-1032",
"EnumerationDate": "07/21/2005",
"LastUpdateDate": "08/23/2018",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": "03/21/2006",
"NPIReactivationDate": "03/27/2006",
"GenderCode": "M",
"Gender": "Male",
"AuthorizedOfficialLastName": null,
"AuthorizedOfficialFirstName": null,
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": null,
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": null,
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "2084N0400X",
"TaxonomyName": "Neurology Physician",
"LicenseNumber": "26536",
"LicenseNumberStateCode": "KY",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}