{
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"EIN": null,
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"IsOrgSubpart": "N",
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"OrgName": "P SABANAYAGAM MD PC",
"LastName": null,
"FirstName": null,
"MiddleName": null,
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"FirstLineMailingAddress": "441 W 21ST ST",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "CHESTER",
"MailingAddressStateName": "PA",
"MailingAddressPostalCode": "19013-4919",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "610-622-9670",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "8201 ARMENT DR",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "GLEN MILLS",
"PracticeLocationAddressStateName": "PA",
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"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "610-622-9670",
"PracticeLocationAddressFaxNumber": "610-459-1035",
"EnumerationDate": "09/09/2007",
"LastUpdateDate": "11/08/2007",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "SABANAYAGAM",
"AuthorizedOfficialFirstName": "P",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "PRESIDENT",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "MD",
"AuthorizedOfficialTelephoneNumber": "610-622-9670",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "174400000X",
"TaxonomyName": "Specialist",
"LicenseNumber": "MD014776E",
"LicenseNumberStateCode": "PA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"HealthcareProviderTaxonomyGroupName": "193400000X SINGLE SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
}
}
}
}