{
"Npi": {
"NPI": "1780765370",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "GREGORY G. CARNEVALE,M.D,L.L.C.",
"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": "784 PRE EMPTION RD",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "GENEVA",
"MailingAddressStateName": "NY",
"MailingAddressPostalCode": "14456-2018",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "315-789-2153",
"MailingAddressFaxNumber": "315-789-4781",
"FirstLinePracticeLocationAddress": "784 PRE EMPTION RD",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "GENEVA",
"PracticeLocationAddressStateName": "NY",
"PracticeLocationAddressPostalCode": "14456-2018",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "315-789-2153",
"PracticeLocationAddressFaxNumber": "315-789-4781",
"EnumerationDate": "10/18/2006",
"LastUpdateDate": "09/11/2025",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "CARNEVALE",
"AuthorizedOfficialFirstName": "GREGORY",
"AuthorizedOfficialMiddleName": "G",
"AuthorizedOfficialTitle": "OWNER",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "M.D.",
"AuthorizedOfficialTelephoneNumber": "315-789-2153",
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "207Y00000X",
"TaxonomyName": "Otolaryngology Physician",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "207YX0602X",
"TaxonomyName": "Otolaryngic Allergy Physician",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": [
{
"HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
},
{
"HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
}
]
}
}
}