{
"Npi": {
"NPI": "1326777335",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "ASTUTE DIAGNOSTICS LLC",
"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": "1077 N CHURCH ST",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "HAZLE TOWNSHIP",
"MailingAddressStateName": "PA",
"MailingAddressPostalCode": "18202-1465",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "570-501-1808",
"MailingAddressFaxNumber": "855-635-6308",
"FirstLinePracticeLocationAddress": "1077 N CHURCH ST",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "HAZLE TOWNSHIP",
"PracticeLocationAddressStateName": "PA",
"PracticeLocationAddressPostalCode": "18202-1465",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "570-501-1808",
"PracticeLocationAddressFaxNumber": "855-635-6308",
"EnumerationDate": "06/06/2022",
"LastUpdateDate": "03/05/2024",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "OH",
"AuthorizedOfficialFirstName": "KATHERINE",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "MEMBER",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "570-501-1808",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "2251E1300X",
"TaxonomyName": "Clinical Electrophysiology Physical Therapist",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"HealthcareProviderTaxonomyGroupName": "193400000X SINGLE SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
}
}
}
}