{
"Npi": {
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"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "OCCUPATIONAL HEALTH SERVICES RPN NP ADULT HEALTH PLLC",
"LastName": null,
"FirstName": null,
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"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
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"OtherOrgNameTypeCode": null,
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"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "PO BOX 375",
"SecondLineMailingAddress": "187-189 CENTER STREET",
"MailingAddressCityName": "SALAMANCA",
"MailingAddressStateName": "NY",
"MailingAddressPostalCode": "14779-0375",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "716-945-2825",
"MailingAddressFaxNumber": "716-945-2827",
"FirstLinePracticeLocationAddress": "187-189 CENTER STREET",
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"PracticeLocationAddressCityName": "SALAMANCA",
"PracticeLocationAddressStateName": "NY",
"PracticeLocationAddressPostalCode": "14779-1454",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "716-945-2825",
"PracticeLocationAddressFaxNumber": "716-945-2827",
"EnumerationDate": "09/05/2007",
"LastUpdateDate": "06/19/2008",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "BRUNO",
"AuthorizedOfficialFirstName": "GWEN",
"AuthorizedOfficialMiddleName": "ELIZABETH",
"AuthorizedOfficialTitle": "MANAGER",
"AuthorizedOfficialNamePrefix": "MS.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "ANP",
"AuthorizedOfficialTelephoneNumber": "716-945-2825",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "363LA2200X",
"TaxonomyName": "Adult Health Nurse Practitioner",
"LicenseNumber": "F303946 1",
"LicenseNumberStateCode": "NY",
"PrimaryTaxonomySwitch": "Y"
}
},
"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."
}
}
}
}