{
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"FirstLineMailingAddress": "13929 BALTIMORE AVE",
"SecondLineMailingAddress": "SUITE#4",
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"MailingAddressPostalCode": "20707-5045",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "301-490-8311",
"MailingAddressFaxNumber": "301-490-8244",
"FirstLinePracticeLocationAddress": "6427 LANDOVER RD",
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"PracticeLocationAddressCityName": "CHEVERLY",
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"PracticeLocationAddressFaxNumber": "301-341-0123",
"EnumerationDate": "03/27/2012",
"LastUpdateDate": "05/24/2012",
"NPIDeactivationReasonCode": null,
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"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "BOKKA",
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"AuthorizedOfficialTelephoneNumber": "718-649-9535",
"Taxonomies": {
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{
"TaxonomyCode": "333600000X",
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"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "3336C0003X",
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}
]
},
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}
}