{
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"FirstLineMailingAddress": "249 S 7TH ST",
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"MailingAddressCityName": "PHILADELPHIA",
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"MailingAddressCountryCode": "US",
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"MailingAddressFaxNumber": "816-208-0207",
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"EnumerationDate": "12/13/2023",
"LastUpdateDate": "02/06/2024",
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"NPIReactivationDate": null,
"GenderCode": null,
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"AuthorizedOfficialLastName": "BRADER",
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"Taxonomies": {
"Taxonomy": {
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"TaxonomyName": "Ophthalmology Physician",
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"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
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"HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
}
}
}
}