{
"Npi": {
"NPI": "1457311987",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "X",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "DAVIDOV",
"FirstName": "LUDMILA",
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "9850 63RD DR",
"SecondLineMailingAddress": "APT# 5G",
"MailingAddressCityName": "REGO PARK",
"MailingAddressStateName": "NY",
"MailingAddressPostalCode": "11374-2337",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "718-275-7485",
"MailingAddressFaxNumber": "718-997-6817",
"FirstLinePracticeLocationAddress": "9745 QUEENS BLVD",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "REGO PARK",
"PracticeLocationAddressStateName": "NY",
"PracticeLocationAddressPostalCode": "11374-2101",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "718-459-0500",
"PracticeLocationAddressFaxNumber": "718-997-6817",
"EnumerationDate": "03/27/2006",
"LastUpdateDate": "07/08/2007",
"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": "2084P0800X",
"TaxonomyName": "Psychiatry Physician",
"LicenseNumber": "221669",
"LicenseNumberStateCode": "NY",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}