{
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"FirstLineMailingAddress": "365 GULF ST",
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"MailingAddressCityName": "MILFORD",
"MailingAddressStateName": "CT",
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"FirstLinePracticeLocationAddress": "58 RIVER ST",
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"PracticeLocationAddressCityName": "MILFORD",
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"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "03/21/2017",
"LastUpdateDate": "03/21/2017",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": "M",
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"Taxonomies": {
"Taxonomy": {
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"LicenseNumber": "1897",
"LicenseNumberStateCode": "CT",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}