{
"Npi": {
"NPI": "1336392653",
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"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "EINSTEIN PRACTICE PLAN, INC",
"LastName": null,
"FirstName": null,
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"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": "6",
"OtherLastName": null,
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"OtherNamePrefix": null,
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"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "101 E OLNEY AVE",
"SecondLineMailingAddress": "SUITE 400",
"MailingAddressCityName": "PHILADELPHIA",
"MailingAddressStateName": "PA",
"MailingAddressPostalCode": "19120-2421",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "215-456-7000",
"MailingAddressFaxNumber": "215-254-2599",
"FirstLinePracticeLocationAddress": "5501 OLD YORK RD",
"SecondLinePracticeLocationAddress": "PALEY BLDG",
"PracticeLocationAddressCityName": "PHILADELPHIA",
"PracticeLocationAddressStateName": "PA",
"PracticeLocationAddressPostalCode": "19141-3018",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "215-456-6990",
"PracticeLocationAddressFaxNumber": "215-254-2599",
"EnumerationDate": "10/30/2008",
"LastUpdateDate": "11/18/2008",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "CONKEY",
"AuthorizedOfficialFirstName": "SUSAN",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "SUPERVISOR",
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"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "215-456-7000",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QF0050X",
"TaxonomyName": "Non-Surgical Family Planning Clinic/Center",
"LicenseNumber": null,
"LicenseNumberStateCode": "PA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}