{
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"FirstLineMailingAddress": "16 BITTERN DR",
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"MailingAddressCityName": "NANUET",
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"MailingAddressCountryCode": "US",
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"FirstLinePracticeLocationAddress": "210 N CENTRAL AVE STE 340A",
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"PracticeLocationAddressCityName": "HARTSDALE",
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"PracticeLocationAddressCountryCode": "US",
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"EnumerationDate": "02/22/2018",
"LastUpdateDate": "02/26/2018",
"NPIDeactivationReasonCode": null,
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"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": "F",
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"Taxonomies": {
"Taxonomy": {
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"LicenseNumber": "022197",
"LicenseNumberStateCode": "NY",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"HealthcareProviderTaxonomyGroupName": "193400000X SINGLE SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
}
}
}
}