{
"Npi": {
"NPI": "1831386440",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "THE BACK CARE CENTER IN TENAFLY LLC",
"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": "89 GRANT AVENUE",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "DUMONT",
"MailingAddressStateName": "NJ",
"MailingAddressPostalCode": "07628",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "201-387-7463",
"MailingAddressFaxNumber": "201-387-2360",
"FirstLinePracticeLocationAddress": "103 N SUMMIT STREET",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "TENAFLY",
"PracticeLocationAddressStateName": "NJ",
"PracticeLocationAddressPostalCode": "07670",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "201-227-1366",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "09/27/2007",
"LastUpdateDate": "09/27/2007",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "SCHWARTZ",
"AuthorizedOfficialFirstName": "DAVID",
"AuthorizedOfficialMiddleName": "BARRY",
"AuthorizedOfficialTitle": "SOLE MEMBER",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "DC",
"AuthorizedOfficialTelephoneNumber": "201-227-1366",
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "111N00000X",
"TaxonomyName": "Chiropractor",
"LicenseNumber": "X00468641",
"LicenseNumberStateCode": "NY",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "111N00000X",
"TaxonomyName": "Chiropractor",
"LicenseNumber": "MC00333700",
"LicenseNumberStateCode": "NJ",
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": [
{
"HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
},
{
"HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
}
]
}
}
}