{
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"FirstLineMailingAddress": "DEPT 3010, PO BOX 986524",
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"MailingAddressCountryCode": "US",
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"FirstLinePracticeLocationAddress": "909 N MAIN ST",
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"PracticeLocationAddressCityName": "PROVIDENCE",
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"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "401-273-4064",
"PracticeLocationAddressFaxNumber": "401-273-1268",
"EnumerationDate": "05/01/2009",
"LastUpdateDate": "05/15/2024",
"NPIDeactivationReasonCode": null,
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"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": "F",
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"Taxonomies": {
"Taxonomy": {
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"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}