{
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"EIN": null,
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"FirstLineMailingAddress": "1200 WELSH RD",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "NORTH WALES",
"MailingAddressStateName": "PA",
"MailingAddressPostalCode": "19454-3771",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "215-393-3550",
"MailingAddressFaxNumber": "215-393-3556",
"FirstLinePracticeLocationAddress": "1200 WELSH RD",
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"PracticeLocationAddressCityName": "NORTH WALES",
"PracticeLocationAddressStateName": "PA",
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"PracticeLocationAddressTelephoneNumber": "973-844-1155",
"PracticeLocationAddressFaxNumber": "973-844-1910",
"EnumerationDate": "07/14/2009",
"LastUpdateDate": "07/14/2009",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "NICOSIA",
"AuthorizedOfficialFirstName": "FRANK",
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"AuthorizedOfficialTitle": "PRESIDENT",
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"AuthorizedOfficialCredential": "DC",
"AuthorizedOfficialTelephoneNumber": "973-844-1155",
"Taxonomies": {
"Taxonomy": {
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"TaxonomyName": "Chiropractor",
"LicenseNumber": null,
"LicenseNumberStateCode": "PA",
"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."
}
}
}
}