{
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"FirstLineMailingAddress": "503 AIRPORT EXECUTIVE PARK",
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"MailingAddressCityName": "NANUET",
"MailingAddressStateName": "NY",
"MailingAddressPostalCode": "10954-5238",
"MailingAddressCountryCode": "US",
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"FirstLinePracticeLocationAddress": "30 W 60TH ST",
"SecondLinePracticeLocationAddress": "SUITE 1H",
"PracticeLocationAddressCityName": "NEW YORK",
"PracticeLocationAddressStateName": "NY",
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"PracticeLocationAddressTelephoneNumber": "212-247-6575",
"PracticeLocationAddressFaxNumber": "212-582-9461",
"EnumerationDate": "12/22/2006",
"LastUpdateDate": "02/20/2009",
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"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "MOORE",
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"Taxonomies": {
"Taxonomy": {
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"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
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"HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
}
}
}
}