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"FirstLineMailingAddress": "70 E 10TH ST",
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"MailingAddressFaxNumber": "212-466-0807",
"FirstLinePracticeLocationAddress": "70 E 10TH ST",
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"PracticeLocationAddressTelephoneNumber": "212-466-0806",
"PracticeLocationAddressFaxNumber": "212-466-0807",
"EnumerationDate": "05/16/2009",
"LastUpdateDate": "09/09/2022",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "WUNDERLICH",
"AuthorizedOfficialFirstName": "DANIEL",
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"AuthorizedOfficialCredential": "DACM, LAC, LMT",
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"Taxonomy": [
{
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},
{
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}
]
},
"HealthcareProviderTaxonomyGroups": {
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{
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},
{
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}
]
}
}
}