{
"Npi": {
"NPI": "1306655642",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "ALLELICA, 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": "447 BROADWAY",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "NEW YORK",
"MailingAddressStateName": "NY",
"MailingAddressPostalCode": "10013-2562",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "202-949-2834",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "7 FIELDSTONE LN",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "NATICK",
"PracticeLocationAddressStateName": "MA",
"PracticeLocationAddressPostalCode": "01760-5560",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "781-258-1454",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "01/02/2025",
"LastUpdateDate": "05/29/2025",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "BOTTA",
"AuthorizedOfficialFirstName": "GIORDANO",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "CEO & CO-FOUNDER",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "PHD",
"AuthorizedOfficialTelephoneNumber": "415-964-5914",
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "261QG0250X",
"TaxonomyName": "Genetics Clinic/Center",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "291U00000X",
"TaxonomyName": "Clinical Medical Laboratory",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}