{
"Npi": {
"NPI": "1588976401",
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"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "ANTHONY BELO PHYSICAL THERAPY PC",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": "6",
"OtherLastName": null,
"OtherFirstName": null,
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"OtherNamePrefix": null,
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"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "23 HILLSIDE AVE",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "WILLISTON PARK",
"MailingAddressStateName": "NY",
"MailingAddressPostalCode": "11596-2357",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "516-307-1515",
"MailingAddressFaxNumber": "516-307-1514",
"FirstLinePracticeLocationAddress": "23 HILLSIDE AVE",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "WILLISTON PARK",
"PracticeLocationAddressStateName": "NY",
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"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "516-307-1515",
"PracticeLocationAddressFaxNumber": "516-307-1514",
"EnumerationDate": "07/08/2010",
"LastUpdateDate": "07/08/2010",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "BELO",
"AuthorizedOfficialFirstName": "ANTHONY",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "PRESIDENT",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "DPT",
"AuthorizedOfficialTelephoneNumber": "516-307-1515",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QP2000X",
"TaxonomyName": "Physical Therapy Clinic/Center",
"LicenseNumber": "0295251",
"LicenseNumberStateCode": "NY",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}