{
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"FirstLineMailingAddress": "221-10 JAMAICA A.",
"SecondLineMailingAddress": "SUITE 103",
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"EnumerationDate": "09/05/2008",
"LastUpdateDate": "10/07/2017",
"NPIDeactivationReasonCode": null,
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"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "FLAX",
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"AuthorizedOfficialCredential": "D.M.D.",
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{
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}
]
},
"HealthcareProviderTaxonomyGroups": {
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},
{
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}
]
}
}
}