{
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"FirstLineMailingAddress": "3662 THE PARK",
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"EnumerationDate": "05/18/2007",
"LastUpdateDate": "09/16/2009",
"NPIDeactivationReasonCode": null,
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"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "MCNEIL",
"AuthorizedOfficialFirstName": "KENNETH",
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"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "607-753-7514",
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{
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},
{
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},
{
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},
{
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}
]
},
"HealthcareProviderTaxonomyGroups": {
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},
{
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}
]
}
}
}