{
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"EIN": null,
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"ParentOrgLBN": null,
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"NamePrefix": null,
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"FirstLineMailingAddress": "8009 37TH AVE",
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"MailingAddressCityName": "JACKSON HEIGHTS",
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"MailingAddressPostalCode": "11372-6719",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "718-406-9040",
"MailingAddressFaxNumber": "718-255-6129",
"FirstLinePracticeLocationAddress": "8009 37TH AVE",
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"PracticeLocationAddressCityName": "JACKSON HEIGHTS",
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"EnumerationDate": "04/22/2016",
"LastUpdateDate": "07/14/2016",
"NPIDeactivationReasonCode": null,
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"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "RESTREPO",
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"AuthorizedOfficialTelephoneNumber": "718-406-9040",
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "333600000X",
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"PrimaryTaxonomySwitch": "N"
},
{
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}
]
},
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}
}