{
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"EIN": null,
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"IsOrgSubpart": "N",
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"OrgName": "RETINA CARE CENTER, P.C.",
"LastName": null,
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"NamePrefix": null,
"NameSuffix": null,
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"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "1255 ROUTE 70 STE 31N",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "LAKEWOOD",
"MailingAddressStateName": "NJ",
"MailingAddressPostalCode": "08701-5973",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "732-905-0004",
"MailingAddressFaxNumber": "732-905-3868",
"FirstLinePracticeLocationAddress": "1255 ROUTE 70 STE 31N",
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"PracticeLocationAddressCityName": "LAKEWOOD",
"PracticeLocationAddressStateName": "NJ",
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"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "732-905-0004",
"PracticeLocationAddressFaxNumber": "732-905-3868",
"EnumerationDate": "08/13/2008",
"LastUpdateDate": "05/03/2017",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "BAROFSKY",
"AuthorizedOfficialFirstName": "JONATHAN",
"AuthorizedOfficialMiddleName": "M",
"AuthorizedOfficialTitle": "PRESIDENT",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "M.D.",
"AuthorizedOfficialTelephoneNumber": "732-920-4700",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "207WX0107X",
"TaxonomyName": "Retina Specialist (Ophthalmology) Physician",
"LicenseNumber": "MA60199",
"LicenseNumberStateCode": "NJ",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
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"HealthcareProviderTaxonomyGroupName": "193400000X 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."
}
}
}
}