{
"Npi": {
"NPI": "1801281472",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "NORUM PHYSICAL THERAPY LLC",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
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"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "95 LINCOLN AVE",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "PEARL RIVER",
"MailingAddressStateName": "NY",
"MailingAddressPostalCode": "10965-1708",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "551-777-3502",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "210 SUMMIT AVE",
"SecondLinePracticeLocationAddress": "SUITE A1A",
"PracticeLocationAddressCityName": "MONTVALE",
"PracticeLocationAddressStateName": "NJ",
"PracticeLocationAddressPostalCode": "07645-1579",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "551-777-3502",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "03/31/2015",
"LastUpdateDate": "03/31/2015",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "NORUM",
"AuthorizedOfficialFirstName": "TIMOTHY",
"AuthorizedOfficialMiddleName": "GERARD",
"AuthorizedOfficialTitle": "PHYSICAL THERAPIST",
"AuthorizedOfficialNamePrefix": "MR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "MSPT",
"AuthorizedOfficialTelephoneNumber": "551-777-3502",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QP2000X",
"TaxonomyName": "Physical Therapy Clinic/Center",
"LicenseNumber": "40QA00798900",
"LicenseNumberStateCode": "NJ",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}