{
"Npi": {
"NPI": "1821054230",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "GILSON",
"FirstName": "NOAH",
"MiddleName": "R",
"NamePrefix": "DR.",
"NameSuffix": null,
"Credential": "MD",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "107 MONMOUTH RD",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "WEST LONG BRANCH",
"MailingAddressStateName": "NJ",
"MailingAddressPostalCode": "07764",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "732-935-1850",
"MailingAddressFaxNumber": "732-544-0494",
"FirstLinePracticeLocationAddress": "107 MONMOUTH RD",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "WEST LONG BRANCH",
"PracticeLocationAddressStateName": "NJ",
"PracticeLocationAddressPostalCode": "07764",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "732-935-1850",
"PracticeLocationAddressFaxNumber": "732-544-0494",
"EnumerationDate": "04/25/2006",
"LastUpdateDate": "03/05/2024",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": "03/01/2024",
"NPIReactivationDate": "03/05/2024",
"GenderCode": "M",
"Gender": "Male",
"AuthorizedOfficialLastName": null,
"AuthorizedOfficialFirstName": null,
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": null,
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": null,
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "2084N0400X",
"TaxonomyName": "Neurology Physician",
"LicenseNumber": "MA47784",
"LicenseNumberStateCode": "NJ",
"PrimaryTaxonomySwitch": "Y"
},
{
"TaxonomyCode": "2084N0400X",
"TaxonomyName": "Neurology Physician",
"LicenseNumber": "47784",
"LicenseNumberStateCode": "NJ",
"PrimaryTaxonomySwitch": "N"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}