{
"Npi": {
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"EIN": null,
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"LastName": "KRAETZ",
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"MiddleName": "G",
"NamePrefix": "MRS.",
"NameSuffix": null,
"Credential": "DPT",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "PESARCHICK",
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"OtherCredential": null,
"OtherLastNameTypeCode": "1",
"FirstLineMailingAddress": "PO BOX 611",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "SKANEATELES",
"MailingAddressStateName": "NY",
"MailingAddressPostalCode": "13152-0611",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "315-291-7042",
"MailingAddressFaxNumber": "315-291-7048",
"FirstLinePracticeLocationAddress": "810 W GENESEE STREET RD",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "SKANEATELES",
"PracticeLocationAddressStateName": "NY",
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"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "315-291-7042",
"PracticeLocationAddressFaxNumber": "315-291-7048",
"EnumerationDate": "08/15/2007",
"LastUpdateDate": "08/29/2019",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": "F",
"Gender": "Female",
"AuthorizedOfficialLastName": null,
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"AuthorizedOfficialTitle": null,
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"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": null,
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "225100000X",
"TaxonomyName": "Physical Therapist",
"LicenseNumber": "029599-1",
"LicenseNumberStateCode": "NY",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"HealthcareProviderTaxonomyGroupName": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
}
}
}
}