{
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"EIN": null,
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"IsOrgSubpart": "N",
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"OrgName": "DERDEN LLC",
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"NamePrefix": null,
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"FirstLineMailingAddress": "388 GARDEN DR",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "BATAVIA",
"MailingAddressStateName": "NY",
"MailingAddressPostalCode": "14020-1767",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "585-768-4670",
"MailingAddressFaxNumber": "585-768-4681",
"FirstLinePracticeLocationAddress": "3000 MOUNT READ BLVD",
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"PracticeLocationAddressCityName": "ROCHESTER",
"PracticeLocationAddressStateName": "NY",
"PracticeLocationAddressPostalCode": "14616-4843",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "585-865-3223",
"PracticeLocationAddressFaxNumber": "585-621-4128",
"EnumerationDate": "03/20/2012",
"LastUpdateDate": "03/20/2012",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "PIRINCCI",
"AuthorizedOfficialFirstName": "DENIZ",
"AuthorizedOfficialMiddleName": "M",
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"AuthorizedOfficialCredential": "M.D.",
"AuthorizedOfficialTelephoneNumber": "585-768-4670",
"Taxonomies": {
"Taxonomy": {
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"TaxonomyName": "Internal Medicine Physician",
"LicenseNumber": "177398",
"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."
}
}
}
}