{
"Npi": {
"NPI": "1760682173",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "Y",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "MODY",
"FirstName": "SUSHAMA",
"MiddleName": null,
"NamePrefix": "DR.",
"NameSuffix": null,
"Credential": "M.D.",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "38 MEADOWLANDS PKWY",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "SECAUCUS",
"MailingAddressStateName": "NJ",
"MailingAddressPostalCode": "07094-2925",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "551-257-7038",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "714 10TH ST",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "SECAUCUS",
"PracticeLocationAddressStateName": "NJ",
"PracticeLocationAddressPostalCode": "07094-2921",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "551-257-7038",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "07/23/2007",
"LastUpdateDate": "12/14/2016",
"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": "207RR0500X",
"TaxonomyName": "Rheumatology Physician",
"LicenseNumber": "25MA08633800",
"LicenseNumberStateCode": "NJ",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}