{
"Npi": {
"NPI": "1821420506",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "MCNYC",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "201 ALLEN ST #1002",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "NEW YORK",
"MailingAddressStateName": "NY",
"MailingAddressPostalCode": "10002-1492",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "917-903-2898",
"MailingAddressFaxNumber": "347-428-0580",
"FirstLinePracticeLocationAddress": "71-20 71ST PL",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "GLENDALE",
"PracticeLocationAddressStateName": "NY",
"PracticeLocationAddressPostalCode": "11385-7250",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "917-903-2898",
"PracticeLocationAddressFaxNumber": "347-428-0580",
"EnumerationDate": "08/05/2013",
"LastUpdateDate": "10/29/2024",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "LA PORTE",
"AuthorizedOfficialFirstName": "SHAR",
"AuthorizedOfficialMiddleName": "AILI",
"AuthorizedOfficialTitle": "CNM",
"AuthorizedOfficialNamePrefix": "MS.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "CNM",
"AuthorizedOfficialTelephoneNumber": "917-903-2898",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "176B00000X",
"TaxonomyName": "Midwife",
"LicenseNumber": "F001372",
"LicenseNumberStateCode": "NY",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"HealthcareProviderTaxonomyGroupName": "193400000X MULTIPLE 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."
}
}
}
}