{
"Npi": {
"NPI": "1790713766",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "CITY OF NEW YORK OFFICE OF PAYROLL ADMINISTRATION",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": "6",
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "42-09 28TH STREET",
"SecondLineMailingAddress": "CN-48",
"MailingAddressCityName": "LONG ISLAND CITY",
"MailingAddressStateName": "NY",
"MailingAddressPostalCode": "11101-4132",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "347-396-6234",
"MailingAddressFaxNumber": "347-396-8961",
"FirstLinePracticeLocationAddress": "6710 ROCKAWAY BEACH BLVD",
"SecondLinePracticeLocationAddress": "NYCDOHMH FAR ROCKAWAY HEALTH CENTER",
"PracticeLocationAddressCityName": "FAR ROCKAWAY",
"PracticeLocationAddressStateName": "NY",
"PracticeLocationAddressPostalCode": "11692",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "718-474-2100",
"PracticeLocationAddressFaxNumber": "718-945-2596",
"EnumerationDate": "06/29/2006",
"LastUpdateDate": "07/21/2016",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "GIRALDO",
"AuthorizedOfficialFirstName": "MARITZA",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "BILLING DIRECTOR",
"AuthorizedOfficialNamePrefix": "MRS.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "347-396-6234",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QC1500X",
"TaxonomyName": "Community Health Clinic/Center",
"LicenseNumber": "7002112R1654",
"LicenseNumberStateCode": "NY",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}