{
"Npi": {
"NPI": "1700282712",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "ROBINSON",
"FirstName": "DANIELLE",
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": "DPT",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "PITYK",
"OtherFirstName": "DANIELLE",
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": "DPT",
"OtherLastNameTypeCode": "1",
"FirstLineMailingAddress": "6201 GREENLEIGH AVE",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "BALTIMORE",
"MailingAddressStateName": "MD",
"MailingAddressPostalCode": "21220-2004",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "410-933-6423",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "4924 CAMPBELL BLVD STE 130A",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "NOTTINGHAM",
"PracticeLocationAddressStateName": "MD",
"PracticeLocationAddressPostalCode": "21236-5909",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "443-442-2700",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "11/18/2014",
"LastUpdateDate": "12/30/2024",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": "F",
"Gender": "Female",
"AuthorizedOfficialLastName": null,
"AuthorizedOfficialFirstName": null,
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": null,
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": null,
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "225100000X",
"TaxonomyName": "Physical Therapist",
"LicenseNumber": "27192",
"LicenseNumberStateCode": "MD",
"PrimaryTaxonomySwitch": "Y"
},
{
"TaxonomyCode": "225100000X",
"TaxonomyName": "Physical Therapist",
"LicenseNumber": "2305209025",
"LicenseNumberStateCode": "VA",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "225100000X",
"TaxonomyName": "Physical Therapist",
"LicenseNumber": "41900",
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "N"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}