{
"Npi": {
"NPI": "1831804822",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "LD ORGANIC HAIR CARE",
"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": "18722 KEESEVILLE AVE",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "SAINT ALBANS",
"MailingAddressStateName": "NY",
"MailingAddressPostalCode": "11412-2332",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": null,
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "10919 FARMERS BLVD",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "SAINT ALBANS",
"PracticeLocationAddressStateName": "NY",
"PracticeLocationAddressPostalCode": "11412-1064",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "929-552-2515",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "01/16/2023",
"LastUpdateDate": "01/16/2023",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "DAYES",
"AuthorizedOfficialFirstName": "LATASHA",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "OWNER",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "631-530-6099",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "335E00000X",
"TaxonomyName": "Prosthetic/Orthotic Supplier",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}