{
"Npi": {
"NPI": "1639348055",
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"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "MICHAEL R DUBIN MD AND WILLIAM R BASTA MD P C",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
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"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "3 SCHOOL ST",
"SecondLineMailingAddress": "STE 303",
"MailingAddressCityName": "GLEN COVE",
"MailingAddressStateName": "NY",
"MailingAddressPostalCode": "11542-2548",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "516-676-2878",
"MailingAddressFaxNumber": "516-674-2256",
"FirstLinePracticeLocationAddress": "3 SCHOOL ST",
"SecondLinePracticeLocationAddress": "STE 303",
"PracticeLocationAddressCityName": "GLEN COVE",
"PracticeLocationAddressStateName": "NY",
"PracticeLocationAddressPostalCode": "11542-2548",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "516-676-2878",
"PracticeLocationAddressFaxNumber": "516-674-2256",
"EnumerationDate": "02/29/2008",
"LastUpdateDate": "12/20/2011",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "BASTA",
"AuthorizedOfficialFirstName": "WILLIAM",
"AuthorizedOfficialMiddleName": "ROBERT",
"AuthorizedOfficialTitle": "PRESIDENT",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "M.D.",
"AuthorizedOfficialTelephoneNumber": "516-676-2878",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261Q00000X",
"TaxonomyName": "Clinic/Center",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}