{
"Npi": {
"NPI": "1699119347",
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"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
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"OrgName": "REHAB PARTNERS PT PC",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
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"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "927 FULTON ST",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "FARMINGDALE",
"MailingAddressStateName": "NY",
"MailingAddressPostalCode": "11735-4206",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "646-863-8353",
"MailingAddressFaxNumber": "201-509-4322",
"FirstLinePracticeLocationAddress": "6009 MYRTLE AVE",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "RIDGEWOOD",
"PracticeLocationAddressStateName": "NY",
"PracticeLocationAddressPostalCode": "11385-5933",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "347-472-1834",
"PracticeLocationAddressFaxNumber": "347-472-1838",
"EnumerationDate": "04/24/2013",
"LastUpdateDate": "06/06/2023",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "GAZDZINSKI",
"AuthorizedOfficialFirstName": "ADAM",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "PRESIDENT",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "DPT, ECS, OCS",
"AuthorizedOfficialTelephoneNumber": "646-863-8353",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "225100000X",
"TaxonomyName": "Physical Therapist",
"LicenseNumber": null,
"LicenseNumberStateCode": "NY",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"HealthcareProviderTaxonomyGroupName": "193400000X MULTIPLE 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."
}
}
}
}