{
"Npi": {
"NPI": "1629282637",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "Y",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "REICHENBECHER",
"FirstName": "MARTIN",
"MiddleName": "PAUL",
"NamePrefix": "DR.",
"NameSuffix": null,
"Credential": "O.D.",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "8192 NATIONAL PIKE",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "ADDISON",
"MailingAddressStateName": "PA",
"MailingAddressPostalCode": "15411-2104",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "814-395-3479",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "1262 VOCKE RD",
"SecondLinePracticeLocationAddress": "STE. 100",
"PracticeLocationAddressCityName": "LAVALE",
"PracticeLocationAddressStateName": "MD",
"PracticeLocationAddressPostalCode": "21502-7720",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "301-729-6525",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "05/09/2007",
"LastUpdateDate": "07/08/2007",
"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": "152W00000X",
"TaxonomyName": "Optometrist",
"LicenseNumber": "TA0613",
"LicenseNumberStateCode": "MD",
"PrimaryTaxonomySwitch": "Y"
},
{
"TaxonomyCode": "152W00000X",
"TaxonomyName": "Optometrist",
"LicenseNumber": "0E004573-T",
"LicenseNumberStateCode": "PA",
"PrimaryTaxonomySwitch": "N"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}