{
"Npi": {
"NPI": "1710724927",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "Y",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "SILIEZAR",
"FirstName": "LORENA",
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": "CCHT",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "SILIEZAR CUADRA",
"OtherFirstName": "LORENA",
"OtherMiddleName": "D.",
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": "CCHT",
"OtherLastNameTypeCode": "2",
"FirstLineMailingAddress": "22943 MEADOW MIST RD",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "CLARKSBURG",
"MailingAddressStateName": "MD",
"MailingAddressPostalCode": "20871-3326",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "301-919-3136",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "20111 CENTURY BLVD STE B",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "GERMANTOWN",
"PracticeLocationAddressStateName": "MD",
"PracticeLocationAddressPostalCode": "20874-9164",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "301-540-4601",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "07/15/2024",
"LastUpdateDate": "07/15/2024",
"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": "247200000X",
"TaxonomyName": "Other Technician",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}