{
"Npi": {
"NPI": "1508429663",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "Y",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "CHOI",
"FirstName": "ANDREW",
"MiddleName": "YOUNG",
"NamePrefix": "DR.",
"NameSuffix": null,
"Credential": "PHD",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "CHOI",
"OtherFirstName": "ANDY",
"OtherMiddleName": null,
"OtherNamePrefix": "DR.",
"OtherNameSuffix": null,
"OtherCredential": "PHD",
"OtherLastNameTypeCode": "5",
"FirstLineMailingAddress": "118 E 124TH ST",
"SecondLineMailingAddress": "PO BOX 29",
"MailingAddressCityName": "NEW YORK",
"MailingAddressStateName": "NY",
"MailingAddressPostalCode": "10035-0029",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "213-335-2282",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "118 E 124TH ST",
"SecondLinePracticeLocationAddress": "PO BOX 29",
"PracticeLocationAddressCityName": "NEW YORK",
"PracticeLocationAddressStateName": "NY",
"PracticeLocationAddressPostalCode": "10035-0029",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "213-335-2282",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "04/15/2019",
"LastUpdateDate": "12/19/2024",
"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": "103TH0100X",
"TaxonomyName": "Health Service Psychologist",
"LicenseNumber": "PSY200001465",
"LicenseNumberStateCode": "DC",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "103TH0100X",
"TaxonomyName": "Health Service Psychologist",
"LicenseNumber": "1916",
"LicenseNumberStateCode": "HI",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "103TH0100X",
"TaxonomyName": "Health Service Psychologist",
"LicenseNumber": "33136",
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}