1427267491 NPI number — MARY BETH BORIO DPT, MS, CERT MDT

NPI Number: 1427267491
Health Care Provider/Practitioner: MARY BETH BORIO DPT, MS, CERT MDT

NPI Number : 1427267491 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1427267491",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "BORIO",
    "FirstName": "MARY BETH",
    "MiddleName": null,
    "NamePrefix": "MS.",
    "NameSuffix": null,
    "Credential": "DPT, MS, CERT MDT",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "BORIO",
    "OtherFirstName": "MARY BETH",
    "OtherMiddleName": null,
    "OtherNamePrefix": "MS.",
    "OtherNameSuffix": null,
    "OtherCredential": "DPT, MS, CERT MDT",
    "OtherLastNameTypeCode": "5",
    "FirstLineMailingAddress": "4401 MEDICAL CENTER DR",
    "SecondLineMailingAddress": "SUITE 401",
    "MailingAddressCityName": "FAYETTEVILLE",
    "MailingAddressStateName": "NY",
    "MailingAddressPostalCode": "13066",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": null,
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "4401 MEDICAL CENTER DR",
    "SecondLinePracticeLocationAddress": "SUITE 401",
    "PracticeLocationAddressCityName": "FAYETTEVILLE",
    "PracticeLocationAddressStateName": "NY",
    "PracticeLocationAddressPostalCode": "13066-6603",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "315-329-7000",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "05/22/2007",
    "LastUpdateDate": "09/05/2014",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "225100000X",
          "TaxonomyName": "Physical Therapist",
          "LicenseNumber": "020786-1",
          "LicenseNumberStateCode": "NY",
          "PrimaryTaxonomySwitch": "Y"
        },
        {
          "TaxonomyCode": "225100000X",
          "TaxonomyName": "Physical Therapist",
          "LicenseNumber": "16920",
          "LicenseNumberStateCode": "MA",
          "PrimaryTaxonomySwitch": "N"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}