{
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"FirstLineMailingAddress": "225 PITKIN ST STE 200",
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"MailingAddressCityName": "EAST HARTFORD",
"MailingAddressStateName": "CT",
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"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "860-610-9009",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "494 ELM ST",
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"PracticeLocationAddressCityName": "STAMFORD",
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"PracticeLocationAddressPostalCode": "06902-5115",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "203-325-0200",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "12/19/2019",
"LastUpdateDate": "05/06/2020",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "SODDEN",
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"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "516-451-3277",
"Taxonomies": {
"Taxonomy": {
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"TaxonomyName": "Skilled Nursing Facility",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}