{
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"FirstLineMailingAddress": "16 MANOR CT",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "NEW CITY",
"MailingAddressStateName": "NY",
"MailingAddressPostalCode": "10956-2221",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "716-553-2550",
"MailingAddressFaxNumber": "949-810-7034",
"FirstLinePracticeLocationAddress": "156 ROUTE 59 STE A2",
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"PracticeLocationAddressCityName": "SUFFERN",
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"EnumerationDate": "03/13/2026",
"LastUpdateDate": "03/13/2026",
"NPIDeactivationReasonCode": null,
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"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "CHIRUMAMILLA",
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"AuthorizedOfficialTitle": "MD",
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"AuthorizedOfficialTelephoneNumber": "716-553-2550",
"Taxonomies": {
"Taxonomy": {
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"TaxonomyName": "Surgery Physician",
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"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
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}
}
}
}