{
"Npi": {
"NPI": "1841391695",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "ELMONT MEDICAL PC",
"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": "PO BOX 30682",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "ELMONT",
"MailingAddressStateName": "NY",
"MailingAddressPostalCode": "11003-0682",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "516-654-5600",
"MailingAddressFaxNumber": "516-354-1480",
"FirstLinePracticeLocationAddress": "135 ROCKMART AVE",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "ELMONT",
"PracticeLocationAddressStateName": "NY",
"PracticeLocationAddressPostalCode": "11003-1731",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "516-354-5600",
"PracticeLocationAddressFaxNumber": "516-354-1480",
"EnumerationDate": "09/26/2006",
"LastUpdateDate": "05/09/2008",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "ACHAMPONG",
"AuthorizedOfficialFirstName": "AKWASI",
"AuthorizedOfficialMiddleName": "AFRIYI",
"AuthorizedOfficialTitle": "PHYSICIAN",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "DO",
"AuthorizedOfficialTelephoneNumber": "516-354-5600",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QP2300X",
"TaxonomyName": "Primary Care Clinic/Center",
"LicenseNumber": "216449",
"LicenseNumberStateCode": "NY",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}