{
"Npi": {
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"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
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"OrgName": "MICHAEL TENENBAUM",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
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"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "430 BEACH 68TH ST",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "ARVERNE",
"MailingAddressStateName": "NY",
"MailingAddressPostalCode": "11692-1407",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "718-474-5200",
"MailingAddressFaxNumber": "718-474-5214",
"FirstLinePracticeLocationAddress": "430 BEACH 68TH ST",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "ARVERNE",
"PracticeLocationAddressStateName": "NY",
"PracticeLocationAddressPostalCode": "11692-1407",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "718-474-5200",
"PracticeLocationAddressFaxNumber": "718-474-5214",
"EnumerationDate": "08/20/2006",
"LastUpdateDate": "03/10/2021",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "PERLES",
"AuthorizedOfficialFirstName": "JACOB",
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"AuthorizedOfficialTitle": "ADMINISTRATOR",
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"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "718-474-5200",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "314000000X",
"TaxonomyName": "Skilled Nursing Facility",
"LicenseNumber": "7003330N",
"LicenseNumberStateCode": "NY",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}