{
"Npi": {
"NPI": "1831606243",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "CORNING",
"FirstName": "MARIAH",
"MiddleName": "GABRIELLE",
"NamePrefix": "MRS.",
"NameSuffix": null,
"Credential": "MSOTR/L",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "BOWERS",
"OtherFirstName": "MARIAH",
"OtherMiddleName": "GABRIELLE",
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": "1",
"FirstLineMailingAddress": "7740 ROCK RIVER RD",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "INTERLAKEN",
"MailingAddressStateName": "NY",
"MailingAddressPostalCode": "14847",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "607-279-7319",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "302 W BUFFALO ST.",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "ITHACA",
"PracticeLocationAddressStateName": "NY",
"PracticeLocationAddressPostalCode": "14850",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "607-247-2209",
"PracticeLocationAddressFaxNumber": "607-758-5271",
"EnumerationDate": "01/08/2018",
"LastUpdateDate": "09/03/2020",
"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": "225X00000X",
"TaxonomyName": "Occupational Therapist",
"LicenseNumber": "022207",
"LicenseNumberStateCode": "NY",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}