{
"Npi": {
"NPI": "1841631389",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "VENTRILLA",
"FirstName": "TONI",
"MiddleName": "MARIE",
"NamePrefix": null,
"NameSuffix": null,
"Credential": "RPA-C",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "515 ABBOTT RD",
"SecondLineMailingAddress": "MARIAN PROFESSIONAL BLDG. STE. 101",
"MailingAddressCityName": "BUFFALO",
"MailingAddressStateName": "NY",
"MailingAddressPostalCode": "14220-1700",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "716-923-9650",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "515 ABBOTT RD",
"SecondLinePracticeLocationAddress": "MARIAN PROFESSIONAL BLDG. STE. 101",
"PracticeLocationAddressCityName": "BUFFALO",
"PracticeLocationAddressStateName": "NY",
"PracticeLocationAddressPostalCode": "14220-1700",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "716-923-9650",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "07/12/2013",
"LastUpdateDate": "07/12/2013",
"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": "363AS0400X",
"TaxonomyName": "Surgical Physician Assistant",
"LicenseNumber": "23016672",
"LicenseNumberStateCode": "NY",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}