{
"Npi": {
"NPI": "1831553460",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "SHEN",
"FirstName": "STEPHANIE",
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": "MD",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "305 7TH AVENUE",
"SecondLineMailingAddress": "SUITE 13C",
"MailingAddressCityName": "NEW YORK",
"MailingAddressStateName": "NY",
"MailingAddressPostalCode": "10001",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "646-647-0022",
"MailingAddressFaxNumber": "646-871-6891",
"FirstLinePracticeLocationAddress": "133-38 41ST ROAD",
"SecondLinePracticeLocationAddress": "SUITE 2N",
"PracticeLocationAddressCityName": "FLUSHING",
"PracticeLocationAddressStateName": "NY",
"PracticeLocationAddressPostalCode": "11355",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "718-939-5200",
"PracticeLocationAddressFaxNumber": "646-871-6891",
"EnumerationDate": "04/10/2016",
"LastUpdateDate": "05/16/2025",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": "F",
"Gender": "Female",
"AuthorizedOfficialLastName": null,
"AuthorizedOfficialFirstName": null,
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": null,
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": null,
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "207L00000X",
"TaxonomyName": "Anesthesiology Physician",
"LicenseNumber": "62619",
"LicenseNumberStateCode": "MN",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "207L00000X",
"TaxonomyName": "Anesthesiology Physician",
"LicenseNumber": "75134",
"LicenseNumberStateCode": "CT",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "207L00000X",
"TaxonomyName": "Anesthesiology Physician",
"LicenseNumber": "306333",
"LicenseNumberStateCode": "NY",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "207LP2900X",
"TaxonomyName": "Pain Medicine (Anesthesiology) Physician",
"LicenseNumber": "306333",
"LicenseNumberStateCode": "NY",
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}