{
"Npi": {
"NPI": "1336507789",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "RYAN MONACO PHYSICAL THERAPY, PLLC",
"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": "31 SHERRILL LN",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "NEW HARTFORD",
"MailingAddressStateName": "NY",
"MailingAddressPostalCode": "13413-2834",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "315-732-0949",
"MailingAddressFaxNumber": "315-732-0960",
"FirstLinePracticeLocationAddress": "2413 STATE ROUTE 5",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "UTICA",
"PracticeLocationAddressStateName": "NY",
"PracticeLocationAddressPostalCode": "13502-7717",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "315-732-0949",
"PracticeLocationAddressFaxNumber": "315-732-0960",
"EnumerationDate": "02/01/2016",
"LastUpdateDate": "07/18/2016",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "MONACO",
"AuthorizedOfficialFirstName": "RYAN",
"AuthorizedOfficialMiddleName": "MIKEL DEBIASE",
"AuthorizedOfficialTitle": "PRESIDENT",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "PT, DPT, ATC",
"AuthorizedOfficialTelephoneNumber": "315-292-4032",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QP2000X",
"TaxonomyName": "Physical Therapy Clinic/Center",
"LicenseNumber": "34595",
"LicenseNumberStateCode": "NY",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}