{
"Npi": {
"NPI": "1700674587",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "OCCUPATIONAL MEDICINE ON THE GO, 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,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "8 QUAIL HOLLOW LN",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "SANDY HOOK",
"MailingAddressStateName": "CT",
"MailingAddressPostalCode": "06482-1284",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "203-733-4046",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "73 SAND PIT RD STE 204",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "DANBURY",
"PracticeLocationAddressStateName": "CT",
"PracticeLocationAddressPostalCode": "06810-4015",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "203-514-2639",
"PracticeLocationAddressFaxNumber": "203-514-2659",
"EnumerationDate": "04/30/2025",
"LastUpdateDate": "07/21/2025",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "ALI",
"AuthorizedOfficialFirstName": "IFTIKHAR",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "MEDICAL DIRECTOR",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "MD",
"AuthorizedOfficialTelephoneNumber": "203-733-4046",
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "261QP2300X",
"TaxonomyName": "Primary Care Clinic/Center",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "261QU0200X",
"TaxonomyName": "Urgent Care Clinic/Center",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "261QX0100X",
"TaxonomyName": "Occupational Medicine Clinic/Center",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}