{
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"FirstLineMailingAddress": "1302 KINGS HWY",
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"MailingAddressCountryCode": "US",
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"MailingAddressFaxNumber": "718-645-8017",
"FirstLinePracticeLocationAddress": "1302 KINGS HWY",
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"PracticeLocationAddressFaxNumber": "718-645-8017",
"EnumerationDate": "10/08/2012",
"LastUpdateDate": "10/08/2012",
"NPIDeactivationReasonCode": null,
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"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "VAYNER",
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"AuthorizedOfficialTelephoneNumber": "718-627-8900",
"Taxonomies": {
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"TaxonomyName": "Eyewear Supplier",
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"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}