{
"Npi": {
"NPI": "1588584122",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "Y",
"ParentOrgLBN": "AHS HOSPITAL CORP",
"ParentOrgTIN": null,
"OrgName": "AHS HOSPITAL CORP",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "201 BERDAN AVE",
"SecondLineMailingAddress": "STE 500",
"MailingAddressCityName": "WAYNE",
"MailingAddressStateName": "NJ",
"MailingAddressPostalCode": "07470-3236",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "973-995-0125",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "201 BERDAN AVE",
"SecondLinePracticeLocationAddress": "STE 500",
"PracticeLocationAddressCityName": "WAYNE",
"PracticeLocationAddressStateName": "NJ",
"PracticeLocationAddressPostalCode": "07470-3236",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "973-995-0125",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "07/15/2026",
"LastUpdateDate": "07/15/2026",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "WALTER",
"AuthorizedOfficialFirstName": "JOSEPH",
"AuthorizedOfficialMiddleName": "MICHAEL",
"AuthorizedOfficialTitle": "CFO",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "610-331-9446",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QH0100X",
"TaxonomyName": "Health Service Clinic/Center",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}