{
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"EIN": null,
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"IsOrgSubpart": "N",
"ParentOrgLBN": null,
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"OrgName": "GIWNY, INC",
"LastName": null,
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"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
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"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "6044 WEXFORD MNR",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "CLARENCE CENTER",
"MailingAddressStateName": "NY",
"MailingAddressPostalCode": "14032-9435",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "917-309-9030",
"MailingAddressFaxNumber": "716-462-6000",
"FirstLinePracticeLocationAddress": "6631 MAIN ST STE 2",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "WILLIAMSVILLE",
"PracticeLocationAddressStateName": "NY",
"PracticeLocationAddressPostalCode": "14221-5934",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "716-240-2296",
"PracticeLocationAddressFaxNumber": "716-462-6000",
"EnumerationDate": "04/24/2018",
"LastUpdateDate": "04/16/2023",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "CHUBINEH",
"AuthorizedOfficialFirstName": "SAMAN",
"AuthorizedOfficialMiddleName": "BAHRAM",
"AuthorizedOfficialTitle": "PRESIDENT",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "MD",
"AuthorizedOfficialTelephoneNumber": "716-240-2296",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "207RG0100X",
"TaxonomyName": "Gastroenterology Physician",
"LicenseNumber": "251164",
"LicenseNumberStateCode": "NY",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"HealthcareProviderTaxonomyGroupName": "193400000X SINGLE SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
}
}
}
}