{
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"FirstLineMailingAddress": "137 UPTON ST",
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"MailingAddressStateName": "NY",
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"FirstLinePracticeLocationAddress": "11 RALPH PL",
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"EnumerationDate": "08/26/2011",
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"NPIReactivationDate": null,
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"AuthorizedOfficialLastName": "MUTTANA",
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"Taxonomies": {
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"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
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}
}
}
}