{
"Npi": {
"NPI": "1518998103",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "MIDDLETOWN EYE CARE PA",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "228 DOVE RUN CENTRE DR",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "MIDDLETOWN",
"MailingAddressStateName": "DE",
"MailingAddressPostalCode": "19709-7971",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "302-378-8818",
"MailingAddressFaxNumber": "302-378-2371",
"FirstLinePracticeLocationAddress": "228 DOVE RUN CENTRE DR",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "MIDDLETOWN",
"PracticeLocationAddressStateName": "DE",
"PracticeLocationAddressPostalCode": "19709-7971",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "302-378-8818",
"PracticeLocationAddressFaxNumber": "302-378-2371",
"EnumerationDate": "07/05/2006",
"LastUpdateDate": "10/12/2020",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "CLUFF",
"AuthorizedOfficialFirstName": "ELIZABETH",
"AuthorizedOfficialMiddleName": "BESSIE",
"AuthorizedOfficialTitle": "PRESIDENT",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "OD",
"AuthorizedOfficialTelephoneNumber": "302-378-8818",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "152W00000X",
"TaxonomyName": "Optometrist",
"LicenseNumber": "DE I3-1235",
"LicenseNumberStateCode": "DE",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"HealthcareProviderTaxonomyGroupName": "193400000X SINGLE SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
}
}
}
}