{
"Npi": {
"NPI": "1700016565",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "NEW YORK AUDIOLOGY CENTER, INC.",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "NEW YORK AUDIOLOGY CENTER, INC.",
"SecondLineMailingAddress": "444 E. 82ND STREET, APT. 28D",
"MailingAddressCityName": "NEW YORK",
"MailingAddressStateName": "NY",
"MailingAddressPostalCode": "10028-5929",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "212-628-4597",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "NEW YORK AUDIOLOGY CENTER, INC.",
"SecondLinePracticeLocationAddress": "444 E. 82ND STREET, APT. 28D",
"PracticeLocationAddressCityName": "NEW YORK",
"PracticeLocationAddressStateName": "NY",
"PracticeLocationAddressPostalCode": "10028-5929",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "212-628-4597",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "07/15/2009",
"LastUpdateDate": "07/15/2009",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "FLAXMAN",
"AuthorizedOfficialFirstName": "SHIELA",
"AuthorizedOfficialMiddleName": "SUSAN",
"AuthorizedOfficialTitle": "MA CCC SLP",
"AuthorizedOfficialNamePrefix": "MRS.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "S.L.P.",
"AuthorizedOfficialTelephoneNumber": "212-499-0691",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "320900000X",
"TaxonomyName": "Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility",
"LicenseNumber": "001073-1",
"LicenseNumberStateCode": "NY",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}