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1336534858 NPI number — MATTHEW MASON COUNIHAN MD

NPI Number: 1336534858
Health Care Provider/Practitioner: MATTHEW MASON COUNIHAN MD

Information about “1336534858” NPI (MATTHEW MASON COUNIHAN MD) exists in 1336534858 in HTML format HTML  |  1336534858 in plain Text format TXT  |  1336534858 in PDF (Portable Document Format) PDF  |  1336534858 in an XML format XML  formats.

NPI Number : 1336534858 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1336534858",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "COUNIHAN",
    "FirstName": "MATTHEW",
    "MiddleName": "MASON",
    "NamePrefix": "DR.",
    "NameSuffix": null,
    "Credential": "MD",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "650 FROM RD STE 420",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "PARAMUS",
    "MailingAddressStateName": "NJ",
    "MailingAddressPostalCode": "07652-3551",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "215-534-4837",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "650 FROM RD STE 420",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "PARAMUS",
    "PracticeLocationAddressStateName": "NJ",
    "PracticeLocationAddressPostalCode": "07652-3551",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "215-534-4837",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "04/01/2015",
    "LastUpdateDate": "10/17/2023",
    "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": "207XX0005X",
          "TaxonomyName": "Sports Medicine (Orthopaedic Surgery) Physician",
          "LicenseNumber": "25MA11864300",
          "LicenseNumberStateCode": "NJ",
          "PrimaryTaxonomySwitch": "Y"
        },
        {
          "TaxonomyCode": "390200000X",
          "TaxonomyName": "Student in an Organized Health Care Education/Training Program",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        }
      ]
    },
    "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."
      }
    }
  }
}
                
            

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