{
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"OrgName": "CONEY ISLAND FAMILY EYECARE",
"LastName": null,
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"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "528 NEPTUNE AVE",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "BROOKLYN",
"MailingAddressStateName": "NY",
"MailingAddressPostalCode": "11224-4004",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "718-996-5323",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "528 NEPTUNE AVE",
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"PracticeLocationAddressCityName": "BROOKLYN",
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"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "718-996-5323",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "12/29/2006",
"LastUpdateDate": "01/06/2012",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "PATSALIS",
"AuthorizedOfficialFirstName": "PAUL",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "PRESIDENT",
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"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "917-721-0928",
"Taxonomies": {
"Taxonomy": {
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"TaxonomyName": "Optometrist",
"LicenseNumber": "4810",
"LicenseNumberStateCode": "NY",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
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"HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
}
}
}
}