{
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"FirstLineMailingAddress": "95 PITMAN ST",
"SecondLineMailingAddress": "SUITE B",
"MailingAddressCityName": "PROVIDENCE",
"MailingAddressStateName": "RI",
"MailingAddressPostalCode": "02906-4311",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "401-437-6777",
"MailingAddressFaxNumber": "401-437-6814",
"FirstLinePracticeLocationAddress": "95 PITMAN ST",
"SecondLinePracticeLocationAddress": "SUITE B",
"PracticeLocationAddressCityName": "PROVIDENCE",
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"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "401-437-6777",
"PracticeLocationAddressFaxNumber": "401-437-6814",
"EnumerationDate": "01/16/2015",
"LastUpdateDate": "02/10/2022",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "VIEAU",
"AuthorizedOfficialFirstName": "COLETTE",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "PEDIATRICIAN",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "MD",
"AuthorizedOfficialTelephoneNumber": "401-662-1604",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "208000000X",
"TaxonomyName": "Pediatrics Physician",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"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."
}
}
}
}