{
"Npi": {
"NPI": "1649492455",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "FARRELL",
"FirstName": "CHRISTINE",
"MiddleName": "A",
"NamePrefix": null,
"NameSuffix": null,
"Credential": "PT",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "ABDULKY",
"OtherFirstName": "CHRISTINE",
"OtherMiddleName": "M",
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": "PT",
"OtherLastNameTypeCode": "1",
"FirstLineMailingAddress": "120 DARWIN DR",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "AMHERST",
"MailingAddressStateName": "NY",
"MailingAddressPostalCode": "14226",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "607-351-2498",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "300 S COUNTY FARM RD",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "WHEATON",
"PracticeLocationAddressStateName": "IL",
"PracticeLocationAddressPostalCode": "60187",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "630-547-8045",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "05/02/2007",
"LastUpdateDate": "06/21/2017",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": "F",
"Gender": "Female",
"AuthorizedOfficialLastName": null,
"AuthorizedOfficialFirstName": null,
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": null,
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": null,
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "225100000X",
"TaxonomyName": "Physical Therapist",
"LicenseNumber": "0284821",
"LicenseNumberStateCode": "NY",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}