{
"Npi": {
"NPI": "1366742744",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "JAKYMEC",
"FirstName": "RENEE",
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": "PA",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "DROBINSKI",
"OtherFirstName": "RENEE",
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": "PA",
"OtherLastNameTypeCode": "1",
"FirstLineMailingAddress": "54 NEW HYDE PARK RD",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "GARDEN CITY",
"MailingAddressStateName": "NY",
"MailingAddressPostalCode": "11530-3948",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "516-488-1313",
"MailingAddressFaxNumber": "516-488-1368",
"FirstLinePracticeLocationAddress": "13800 TAMIAMI TRL N STE 112",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "NAPLES",
"PracticeLocationAddressStateName": "FL",
"PracticeLocationAddressPostalCode": "34110-6204",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "516-488-1313",
"PracticeLocationAddressFaxNumber": "516-488-1368",
"EnumerationDate": "11/01/2010",
"LastUpdateDate": "06/07/2023",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": "F",
"Gender": "Female",
"AuthorizedOfficialLastName": null,
"AuthorizedOfficialFirstName": null,
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": null,
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": null,
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "363AM0700X",
"TaxonomyName": "Medical Physician Assistant",
"LicenseNumber": "014351-1",
"LicenseNumberStateCode": "NY",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}