{
"Npi": {
"NPI": "1649496175",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "HU NAM NAM MD",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "13625 MAPLE AVE",
"SecondLineMailingAddress": "SUITE 201",
"MailingAddressCityName": "FLUSHING",
"MailingAddressStateName": "NY",
"MailingAddressPostalCode": "11355-3870",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "718-886-3300",
"MailingAddressFaxNumber": "718-886-8117",
"FirstLinePracticeLocationAddress": "13625 MAPLE AVE",
"SecondLinePracticeLocationAddress": "SUITE 201",
"PracticeLocationAddressCityName": "FLUSHING",
"PracticeLocationAddressStateName": "NY",
"PracticeLocationAddressPostalCode": "11355-3870",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "718-886-3300",
"PracticeLocationAddressFaxNumber": "718-886-8117",
"EnumerationDate": "04/17/2007",
"LastUpdateDate": "08/22/2020",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "NAM",
"AuthorizedOfficialFirstName": "HU",
"AuthorizedOfficialMiddleName": "NAM",
"AuthorizedOfficialTitle": "OWNER",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "MD",
"AuthorizedOfficialTelephoneNumber": "718-886-3300",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QC1800X",
"TaxonomyName": "Corporate Health Clinic/Center",
"LicenseNumber": "163382",
"LicenseNumberStateCode": "NY",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}