{
"Npi": {
"NPI": "1487032488",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "Y",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "GLASER",
"FirstName": "DANIEL",
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": "M.D., M.P.H.",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "PO BOX 208064",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "NEW HAVEN",
"MailingAddressStateName": "CT",
"MailingAddressPostalCode": "06520-8064",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "203-246-0679",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "333 CEDAR ST",
"SecondLinePracticeLocationAddress": "YNHH - DEPARTMENT OF PEDIATRICS",
"PracticeLocationAddressCityName": "NEW HAVEN",
"PracticeLocationAddressStateName": "CT",
"PracticeLocationAddressPostalCode": "06510-3206",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "203-688-1947",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "05/11/2015",
"LastUpdateDate": "07/02/2021",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": "M",
"Gender": "Male",
"AuthorizedOfficialLastName": null,
"AuthorizedOfficialFirstName": null,
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": null,
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": null,
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "208000000X",
"TaxonomyName": "Pediatrics Physician",
"LicenseNumber": "MD465877",
"LicenseNumberStateCode": "PA",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "390200000X",
"TaxonomyName": "Student in an Organized Health Care Education/Training Program",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "2080P0216X",
"TaxonomyName": "Pediatric Rheumatology Physician",
"LicenseNumber": "68777",
"LicenseNumberStateCode": "CT",
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}