{
"Npi": {
"NPI": "1558809673",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "CDPAP HOME CARE SERVICE INC.",
"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": "142-18 38TH AVENUE",
"SecondLineMailingAddress": "SUITE #CFD",
"MailingAddressCityName": "FLUSHING",
"MailingAddressStateName": "NY",
"MailingAddressPostalCode": "11354-5554",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "718-614-7000",
"MailingAddressFaxNumber": "718-888-0025",
"FirstLinePracticeLocationAddress": "142-18 38TH AVENUE",
"SecondLinePracticeLocationAddress": "SUITE #CFD",
"PracticeLocationAddressCityName": "FLUSHING",
"PracticeLocationAddressStateName": "NY",
"PracticeLocationAddressPostalCode": "11354-5554",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "718-614-7000",
"PracticeLocationAddressFaxNumber": "718-888-0025",
"EnumerationDate": "02/09/2017",
"LastUpdateDate": "02/28/2024",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "YUN",
"AuthorizedOfficialFirstName": "PYONG",
"AuthorizedOfficialMiddleName": "SUN",
"AuthorizedOfficialTitle": "OWNER/PRESIDENT",
"AuthorizedOfficialNamePrefix": "MR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "718-614-7000",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "251E00000X",
"TaxonomyName": "Home Health Agency",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}