{
"Npi": {
"NPI": "1841217270",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "Y",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "BANKOV",
"FirstName": "ALEXANDER",
"MiddleName": "BORISOVICH",
"NamePrefix": null,
"NameSuffix": null,
"Credential": "M.D.",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "BANKOV",
"OtherFirstName": "ALEKSANDR",
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": "M.D.",
"OtherLastNameTypeCode": "1",
"FirstLineMailingAddress": "114 MAPLEWOOD DR",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "BEAVER",
"MailingAddressStateName": "PA",
"MailingAddressPostalCode": "15009-1337",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "724-709-9885",
"MailingAddressFaxNumber": "724-774-1517",
"FirstLinePracticeLocationAddress": "114 MAPLEWOOD DR",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "BEAVER",
"PracticeLocationAddressStateName": "PA",
"PracticeLocationAddressPostalCode": "15009-1337",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "724-709-9885",
"PracticeLocationAddressFaxNumber": "724-774-1517",
"EnumerationDate": "07/15/2006",
"LastUpdateDate": "06/13/2021",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": "M",
"Gender": "Male",
"AuthorizedOfficialLastName": null,
"AuthorizedOfficialFirstName": null,
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": null,
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": null,
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "207L00000X",
"TaxonomyName": "Anesthesiology Physician",
"LicenseNumber": "MD073454L",
"LicenseNumberStateCode": "PA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}