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1568958700 NPI number — NURSE PRACTITIONER INFANT AND CHILD HEALTHCARE, PC

NPI Number: 1568958700
Health Care Provider/Practitioner: NURSE PRACTITIONER INFANT AND CHILD HEALTHCARE, PC

Information about “1568958700” NPI (NURSE PRACTITIONER INFANT AND CHILD HEALTHCARE, PC) exists in 1568958700 in HTML format HTML  |  1568958700 in plain Text format TXT  |  1568958700 in PDF (Portable Document Format) PDF  |  1568958700 in an XML format XML  formats.

NPI Number : 1568958700 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1568958700",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "NURSE PRACTITIONER INFANT AND CHILD HEALTHCARE, PC",
    "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": "PO BOX 631",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "MILLER PLACE",
    "MailingAddressStateName": "NY",
    "MailingAddressPostalCode": "11764",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "631-235-2401",
    "MailingAddressFaxNumber": "631-689-3993",
    "FirstLinePracticeLocationAddress": "1227 MAIN STREET",
    "SecondLinePracticeLocationAddress": "SUITE 201",
    "PracticeLocationAddressCityName": "PORT JEFFERSON",
    "PracticeLocationAddressStateName": "NY",
    "PracticeLocationAddressPostalCode": "11777",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "631-235-2401",
    "PracticeLocationAddressFaxNumber": "631-689-3993",
    "EnumerationDate": "07/10/2018",
    "LastUpdateDate": "07/10/2018",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "TRIOLO",
    "AuthorizedOfficialFirstName": "MICHELE",
    "AuthorizedOfficialMiddleName": "A.",
    "AuthorizedOfficialTitle": "PRESIDENT",
    "AuthorizedOfficialNamePrefix": "MS.",
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": "LPNP, NPP",
    "AuthorizedOfficialTelephoneNumber": "631-235-2401",
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "363LP0200X",
          "TaxonomyName": "Pediatric Nurse Practitioner",
          "LicenseNumber": "380749",
          "LicenseNumberStateCode": "NY",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "363LP0808X",
          "TaxonomyName": "Psychiatric/Mental Health Nurse Practitioner",
          "LicenseNumber": "F-400866-1",
          "LicenseNumberStateCode": "NY",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": {
      "HealthcareProviderTaxonomyGroup": [
        {
          "HealthcareProviderTaxonomyGroupName": "193400000X MULTIPLE 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."
        },
        {
          "HealthcareProviderTaxonomyGroupName": "193400000X MULTIPLE 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."
        }
      ]
    }
  }
}
                
            

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