{
"Npi": {
"NPI": "1326120601",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "Y",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "RUBIN",
"FirstName": "BARRY",
"MiddleName": null,
"NamePrefix": "DR.",
"NameSuffix": null,
"Credential": "M.D.",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "46 ROUTE 25A",
"SecondLineMailingAddress": "SUTIE 4",
"MailingAddressCityName": "SETAUKET",
"MailingAddressStateName": "NY",
"MailingAddressPostalCode": "11733-2820",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "631-246-9501",
"MailingAddressFaxNumber": "631-246-9570",
"FirstLinePracticeLocationAddress": "635 BELLE TERRE RD STE 209B",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "PORT JEFFERSON",
"PracticeLocationAddressStateName": "NY",
"PracticeLocationAddressPostalCode": "11777-1935",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "631-246-9501",
"PracticeLocationAddressFaxNumber": "631-246-9570",
"EnumerationDate": "10/19/2006",
"LastUpdateDate": "02/11/2022",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": "M",
"Gender": "Male",
"AuthorizedOfficialLastName": null,
"AuthorizedOfficialFirstName": null,
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": null,
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": null,
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "208100000X",
"TaxonomyName": "Physical Medicine & Rehabilitation Physician",
"LicenseNumber": "169794-1",
"LicenseNumberStateCode": "NY",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}