{
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"EIN": null,
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"IsOrgSubpart": "N",
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"OrgName": "TOWN NISKAYUNA CONSOLIDATED FIRE DIST 1",
"LastName": null,
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"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
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"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "1079 BALLTOWN ROAD",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "NISKAYUNA",
"MailingAddressStateName": "NY",
"MailingAddressPostalCode": "12309",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "518-374-8386",
"MailingAddressFaxNumber": "518-374-3037",
"FirstLinePracticeLocationAddress": "1079 BALLTOWN ROAD",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "NISKAYUNA",
"PracticeLocationAddressStateName": "NY",
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"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "518-374-8386",
"PracticeLocationAddressFaxNumber": "518-374-3037",
"EnumerationDate": "05/03/2007",
"LastUpdateDate": "08/17/2022",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "LINGENFELTER",
"AuthorizedOfficialFirstName": "DALE",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "CHIEF",
"AuthorizedOfficialNamePrefix": "MR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "EMT-PARAMEDIC",
"AuthorizedOfficialTelephoneNumber": "518-374-8386",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "3416L0300X",
"TaxonomyName": "Land Ambulance",
"LicenseNumber": "4619",
"LicenseNumberStateCode": "NY",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}