{
"Npi": {
"NPI": "1740778802",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "RYAN CHOW PT 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": "5024 192ND ST",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "FRESH MEADOWS",
"MailingAddressStateName": "NY",
"MailingAddressPostalCode": "11365-1214",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "718-908-4680",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "80 5TH AVE FL 2",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "NEW YORK",
"PracticeLocationAddressStateName": "NY",
"PracticeLocationAddressPostalCode": "10011-8002",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "510-858-6779",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "04/24/2018",
"LastUpdateDate": "01/07/2022",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "CHOW",
"AuthorizedOfficialFirstName": "RYAN",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "PHYSICAL THERAPIST",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "DPT",
"AuthorizedOfficialTelephoneNumber": "718-908-4680",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "2251X0800X",
"TaxonomyName": "Orthopedic Physical Therapist",
"LicenseNumber": "041674",
"LicenseNumberStateCode": "NY",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"HealthcareProviderTaxonomyGroupName": "193400000X SINGLE SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
}
}
}
}