{
"Npi": {
"NPI": "1508929274",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "REHABILITATION",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": "6",
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "210 E 102ND ST",
"SecondLineMailingAddress": "#13H",
"MailingAddressCityName": "NEW YORK",
"MailingAddressStateName": "NY",
"MailingAddressPostalCode": "10029-5937",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "212-876-0659",
"MailingAddressFaxNumber": "212-876-0659",
"FirstLinePracticeLocationAddress": "210 E 102ND ST",
"SecondLinePracticeLocationAddress": "#13H",
"PracticeLocationAddressCityName": "NEW YORK",
"PracticeLocationAddressStateName": "NY",
"PracticeLocationAddressPostalCode": "10029-5937",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "212-876-0659",
"PracticeLocationAddressFaxNumber": "212-876-0659",
"EnumerationDate": "12/17/2006",
"LastUpdateDate": "08/22/2020",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "MATTEI",
"AuthorizedOfficialFirstName": "MARINA",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "OCCUPATIONAL THERAPIST ASSISTANT",
"AuthorizedOfficialNamePrefix": "MS.",
"AuthorizedOfficialNameSuffix": "I",
"AuthorizedOfficialCredential": "O.T.A.",
"AuthorizedOfficialTelephoneNumber": "917-470-7040",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "320700000X",
"TaxonomyName": "Physical Disabilities Residential Treatment Facility",
"LicenseNumber": "003295-1",
"LicenseNumberStateCode": "NY",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}