1861658676 NPI number — NANCY ELIZABETH MARTIN M.D., PHARM.D., FCP

NPI Number: 1861658676
Health Care Provider/Practitioner: NANCY ELIZABETH MARTIN M.D., PHARM.D., FCP

NPI Number : 1861658676 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1861658676",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "MARTIN",
    "FirstName": "NANCY",
    "MiddleName": "ELIZABETH",
    "NamePrefix": "DR.",
    "NameSuffix": null,
    "Credential": "M.D., PHARM.D., FCP",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "ALGRANATI",
    "OtherFirstName": "NANCY",
    "OtherMiddleName": "ELIZABETH",
    "OtherNamePrefix": "DR.",
    "OtherNameSuffix": null,
    "OtherCredential": "M.D., PHARM.D., FCP",
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "327 SHERIDAN RD",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "WILMETTE",
    "MailingAddressStateName": "IL",
    "MailingAddressPostalCode": "60091-3453",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "224-515-6177",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "327 SHERIDAN RD",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "WILMETTE",
    "PracticeLocationAddressStateName": "IL",
    "PracticeLocationAddressPostalCode": "60091-3453",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "224-515-6177",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "07/31/2008",
    "LastUpdateDate": "01/01/2014",
    "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": "183500000X",
          "TaxonomyName": "Pharmacist",
          "LicenseNumber": "28RI02575400",
          "LicenseNumberStateCode": "NJ",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "183500000X",
          "TaxonomyName": "Pharmacist",
          "LicenseNumber": "051286184",
          "LicenseNumberStateCode": "IL",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "207R00000X",
          "TaxonomyName": "Internal Medicine Physician",
          "LicenseNumber": "260054",
          "LicenseNumberStateCode": "NY",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}