{
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"IsOrgSubpart": "N",
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"OrgName": "PREMIERE FOOT AND ANKLE PC",
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"FirstLineMailingAddress": "444 PERRY DR",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "NORTH BRUNSWICK",
"MailingAddressStateName": "NJ",
"MailingAddressPostalCode": "08902-5801",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "908-421-4545",
"MailingAddressFaxNumber": "732-545-2880",
"FirstLinePracticeLocationAddress": "1527 STATE HIGHWAY 27",
"SecondLinePracticeLocationAddress": "SUITE 1100",
"PracticeLocationAddressCityName": "SOMERSET",
"PracticeLocationAddressStateName": "NJ",
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"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "908-421-4545",
"PracticeLocationAddressFaxNumber": "732-545-2880",
"EnumerationDate": "03/08/2013",
"LastUpdateDate": "03/08/2013",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "VOLOSOV",
"AuthorizedOfficialFirstName": "ROCHELLE",
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"AuthorizedOfficialTitle": "PHYSICIAN OWNER",
"AuthorizedOfficialNamePrefix": "DR.",
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"AuthorizedOfficialCredential": "DPM",
"AuthorizedOfficialTelephoneNumber": "908-421-4545",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "213E00000X",
"TaxonomyName": "Podiatrist",
"LicenseNumber": "25MD00311000",
"LicenseNumberStateCode": "NJ",
"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."
}
}
}
}