{
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"FirstLineMailingAddress": "2100 STATE ROUTE 33 STE 3",
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"MailingAddressCityName": "NEPTUNE",
"MailingAddressStateName": "NJ",
"MailingAddressPostalCode": "07753-6116",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "732-776-7260",
"MailingAddressFaxNumber": "732-774-8370",
"FirstLinePracticeLocationAddress": "2100 STATE ROUTE 33 STE 3",
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"PracticeLocationAddressFaxNumber": "732-774-8370",
"EnumerationDate": "04/10/2007",
"LastUpdateDate": "02/08/2022",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "SUSSMAN",
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"AuthorizedOfficialCredential": "D.P.M.",
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"Taxonomies": {
"Taxonomy": {
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"TaxonomyName": "Podiatrist",
"LicenseNumber": "25MD01549000",
"LicenseNumberStateCode": "NJ",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
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"HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
}
}
}
}