{
"Npi": {
"NPI": "1427502327",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "JAMES M. INZERILLO, MD, PLLC",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": "6",
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "821 PRE EMPTION RD",
"SecondLineMailingAddress": "SUITE 200",
"MailingAddressCityName": "GENEVA",
"MailingAddressStateName": "NY",
"MailingAddressPostalCode": "14456-2061",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "315-325-4422",
"MailingAddressFaxNumber": "315-325-4373",
"FirstLinePracticeLocationAddress": "821 PRE EMPTION RD",
"SecondLinePracticeLocationAddress": "SUITE 200",
"PracticeLocationAddressCityName": "GENEVA",
"PracticeLocationAddressStateName": "NY",
"PracticeLocationAddressPostalCode": "14456-2061",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "315-325-4422",
"PracticeLocationAddressFaxNumber": "315-325-4373",
"EnumerationDate": "08/09/2016",
"LastUpdateDate": "10/25/2016",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "INZERILLO",
"AuthorizedOfficialFirstName": "JAMES",
"AuthorizedOfficialMiddleName": "MICHAEL",
"AuthorizedOfficialTitle": "MEDICAL DIRECTOR /OWNER",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "M.D.",
"AuthorizedOfficialTelephoneNumber": "631-766-0811",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "208100000X",
"TaxonomyName": "Physical Medicine & Rehabilitation Physician",
"LicenseNumber": "253084",
"LicenseNumberStateCode": "NY",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
}
}
}
}