{
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"LastName": null,
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"NamePrefix": null,
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"FirstLineMailingAddress": "68 HAUPPAUGE RD",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "COMMACK",
"MailingAddressStateName": "NY",
"MailingAddressPostalCode": "11725-4403",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "631-715-2600",
"MailingAddressFaxNumber": "631-715-2908",
"FirstLinePracticeLocationAddress": "68 HAUPPAUGE RD",
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"PracticeLocationAddressCityName": "COMMACK",
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"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "631-715-2600",
"PracticeLocationAddressFaxNumber": "631-715-2908",
"EnumerationDate": "03/16/2009",
"LastUpdateDate": "09/10/2020",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "VITERITTI",
"AuthorizedOfficialFirstName": "LOUIS",
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"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "631-715-2511",
"Taxonomies": {
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"TaxonomyName": "Adult Day Care Clinic/Center",
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"LicenseNumberStateCode": "NY",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}