{
"Npi": {
"NPI": "1306091681",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "CARMEN ANDINO INC.",
"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": "300 BLACK MEADOW RD",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "CHESTER",
"MailingAddressStateName": "NY",
"MailingAddressPostalCode": "10918-2227",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "845-325-6348",
"MailingAddressFaxNumber": "845-610-3803",
"FirstLinePracticeLocationAddress": "300 BLACK MEADOW RD",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "CHESTER",
"PracticeLocationAddressStateName": "NY",
"PracticeLocationAddressPostalCode": "10918-2227",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "845-325-6348",
"PracticeLocationAddressFaxNumber": "845-610-3803",
"EnumerationDate": "11/30/2008",
"LastUpdateDate": "11/30/2008",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "ANDINO",
"AuthorizedOfficialFirstName": "CARMEN",
"AuthorizedOfficialMiddleName": "MILAGROS",
"AuthorizedOfficialTitle": "BILINGUAL/SPECIAL EDUCATION TEACHER",
"AuthorizedOfficialNamePrefix": "MRS.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "MSSED",
"AuthorizedOfficialTelephoneNumber": "845-325-6348",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "252Y00000X",
"TaxonomyName": "Early Intervention Provider Agency",
"LicenseNumber": "124609107",
"LicenseNumberStateCode": "NY",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}