{
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"EIN": null,
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"NamePrefix": null,
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"Credential": null,
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"FirstLineMailingAddress": "1265 SAINT NICHOLAS AVE",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "NEW YORK",
"MailingAddressStateName": "NY",
"MailingAddressPostalCode": "10033-7266",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "212-781-4214",
"MailingAddressFaxNumber": "212-781-4758",
"FirstLinePracticeLocationAddress": "1265 SAINT NICHOLAS AVE",
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"PracticeLocationAddressCityName": "NEW YORK",
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"PracticeLocationAddressTelephoneNumber": "212-781-4214",
"PracticeLocationAddressFaxNumber": "212-281-4758",
"EnumerationDate": "11/19/2009",
"LastUpdateDate": "10/11/2013",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "DESAI",
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"AuthorizedOfficialTitle": "PHARMACIST",
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"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "212-781-4214",
"Taxonomies": {
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{
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"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "3336C0003X",
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}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}