{
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"IsOrgSubpart": "N",
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"OrgName": "CT PHYSICAL THERAPY CARE, P.C.",
"LastName": null,
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"FirstLineMailingAddress": "4310 52ND ST",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "WOODSIDE",
"MailingAddressStateName": "NY",
"MailingAddressPostalCode": "11377-4542",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "347-989-7979",
"MailingAddressFaxNumber": "718-255-1288",
"FirstLinePracticeLocationAddress": "4310 52ND ST",
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"PracticeLocationAddressCityName": "WOODSIDE",
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"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "347-989-7979",
"PracticeLocationAddressFaxNumber": "718-255-1288",
"EnumerationDate": "02/14/2011",
"LastUpdateDate": "10/22/2012",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "TOLENTINO",
"AuthorizedOfficialFirstName": "CHESTER JAY",
"AuthorizedOfficialMiddleName": "REGANIT",
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"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "PHYSICAL THERAPIST",
"AuthorizedOfficialTelephoneNumber": "347-989-7979",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "225100000X",
"TaxonomyName": "Physical Therapist",
"LicenseNumber": "029899",
"LicenseNumberStateCode": "NY",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
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"HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
}
}
}
}