{
"Npi": {
"NPI": "1609009372",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "SALAMANCE FAMILY HEALTH CENTER",
"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": "10 DEVEREUX DR",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "ALLEGANY",
"MailingAddressStateName": "NY",
"MailingAddressPostalCode": "14706-1105",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "812-322-0970",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "4039 ROUTE 219",
"SecondLinePracticeLocationAddress": "SUITE 102",
"PracticeLocationAddressCityName": "SALAMANCA",
"PracticeLocationAddressStateName": "NY",
"PracticeLocationAddressPostalCode": "14779-9625",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "716-945-3000",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "08/28/2009",
"LastUpdateDate": "08/28/2009",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "SHEIKH",
"AuthorizedOfficialFirstName": "ZIA",
"AuthorizedOfficialMiddleName": "MOHAMMED",
"AuthorizedOfficialTitle": "OWNER",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "MD",
"AuthorizedOfficialTelephoneNumber": "716-945-3000",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QP2300X",
"TaxonomyName": "Primary Care Clinic/Center",
"LicenseNumber": "03421",
"LicenseNumberStateCode": "NY",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}