{
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"FirstLineMailingAddress": "PO BOX 788735",
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"MailingAddressCityName": "PHILADELPHIA",
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"MailingAddressTelephoneNumber": "215-456-7000",
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"FirstLinePracticeLocationAddress": "9880 BUSTLETON AVE STE 220",
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"PracticeLocationAddressCityName": "PHILADELPHIA",
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"PracticeLocationAddressTelephoneNumber": "215-456-7900",
"PracticeLocationAddressFaxNumber": "215-281-1585",
"EnumerationDate": "03/26/2019",
"LastUpdateDate": "09/05/2025",
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"NPIReactivationDate": null,
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"AuthorizedOfficialLastName": "NICHOLSON",
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"AuthorizedOfficialTelephoneNumber": "215-456-8129",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "207XS0106X",
"TaxonomyName": "Orthopaedic Hand Surgery Physician",
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"PrimaryTaxonomySwitch": "Y"
}
},
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}
}
}
}