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1649563370 NPI number — MR. GARRY ELIE LAQUINTE

NPI Number: 1649563370
Health Care Provider/Practitioner: MR. GARRY ELIE LAQUINTE

Information about “1649563370” NPI (MR. GARRY ELIE LAQUINTE) exists in 1649563370 in HTML format HTML  |  1649563370 in plain Text format TXT  |  1649563370 in PDF (Portable Document Format) PDF  |  1649563370 in an XML format XML  formats.

NPI Number : 1649563370 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1649563370",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "LAQUINTE",
    "FirstName": "GARRY",
    "MiddleName": "ELIE",
    "NamePrefix": "MR.",
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "LAQUINTE",
    "OtherFirstName": "GARRY",
    "OtherMiddleName": "ELIE",
    "OtherNamePrefix": "MR.",
    "OtherNameSuffix": null,
    "OtherCredential": "PA",
    "OtherLastNameTypeCode": "2",
    "FirstLineMailingAddress": "481 E 52ND ST",
    "SecondLineMailingAddress": "APT 2",
    "MailingAddressCityName": "BROOKLYN",
    "MailingAddressStateName": "NY",
    "MailingAddressPostalCode": "11203-4524",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "718-922-1444",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "45 RIVINGTON ST",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "NEW YORK",
    "PracticeLocationAddressStateName": "NY",
    "PracticeLocationAddressPostalCode": "10002-1304",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "212-539-6460",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "05/27/2011",
    "LastUpdateDate": "05/27/2011",
    "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": "363AM0700X",
        "TaxonomyName": "Medical Physician Assistant",
        "LicenseNumber": "010988",
        "LicenseNumberStateCode": "NY",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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