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1417963166 NPI number — LAWRENCE A PARDEE III MD

NPI Number: 1417963166
Health Care Provider/Practitioner: LAWRENCE A PARDEE III MD

Information about “1417963166” NPI (LAWRENCE A PARDEE III MD) exists in 1417963166 in HTML format HTML  |  1417963166 in plain Text format TXT  |  1417963166 in PDF (Portable Document Format) PDF  |  1417963166 in an XML format XML  formats.

NPI Number : 1417963166 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1417963166",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "PARDEE",
    "FirstName": "LAWRENCE",
    "MiddleName": "A",
    "NamePrefix": "DR.",
    "NameSuffix": "III",
    "Credential": "MD",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "PARDEE",
    "OtherFirstName": "L.",
    "OtherMiddleName": "ALLEN",
    "OtherNamePrefix": "DR.",
    "OtherNameSuffix": "III",
    "OtherCredential": "MD",
    "OtherLastNameTypeCode": "5",
    "FirstLineMailingAddress": "199 PARRISH ST",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "CANANDAIGUA",
    "MailingAddressStateName": "NY",
    "MailingAddressPostalCode": "14424-1788",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "585-394-6811",
    "MailingAddressFaxNumber": "585-394-7497",
    "FirstLinePracticeLocationAddress": "199 PARRISH ST",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "CANANDAIGUA",
    "PracticeLocationAddressStateName": "NY",
    "PracticeLocationAddressPostalCode": "14424-1788",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "585-394-6811",
    "PracticeLocationAddressFaxNumber": "585-394-7497",
    "EnumerationDate": "08/01/2006",
    "LastUpdateDate": "05/22/2014",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "M",
    "Gender": "Male",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "2084N0400X",
        "TaxonomyName": "Neurology Physician",
        "LicenseNumber": "222909",
        "LicenseNumberStateCode": "NY",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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