{
"Npi": {
"NPI": "1609285121",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "LOCANDRO",
"FirstName": "NICHOLAS",
"MiddleName": null,
"NamePrefix": "DR.",
"NameSuffix": null,
"Credential": "PT, ATC",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "100 MCKINLEY AVE STE 2",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "MANAHAWKIN",
"MailingAddressStateName": "NJ",
"MailingAddressPostalCode": "08050-6056",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "609-912-3243",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "100 MCKINLEY AVE STE 2",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "MANAHAWKIN",
"PracticeLocationAddressStateName": "NJ",
"PracticeLocationAddressPostalCode": "08050-6056",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "609-912-3243",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "08/08/2014",
"LastUpdateDate": "01/03/2026",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": "M",
"Gender": "Male",
"AuthorizedOfficialLastName": null,
"AuthorizedOfficialFirstName": null,
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": null,
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": null,
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "2255A2300X",
"TaxonomyName": "Athletic Trainer",
"LicenseNumber": "25MT00264500",
"LicenseNumberStateCode": "NJ",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "225100000X",
"TaxonomyName": "Physical Therapist",
"LicenseNumber": "40QA01861500",
"LicenseNumberStateCode": "NJ",
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}