{
"Npi": {
"NPI": "1871850438",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "ONDERI",
"FirstName": "SIMON",
"MiddleName": "PETER",
"NamePrefix": null,
"NameSuffix": null,
"Credential": "M.D",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "PO BOX 208042",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "NEW HAVEN",
"MailingAddressStateName": "CT",
"MailingAddressPostalCode": "06520-8042",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "203-785-5253",
"MailingAddressFaxNumber": "203-785-3024",
"FirstLinePracticeLocationAddress": "20 YORK ST",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "NEW HAVEN",
"PracticeLocationAddressStateName": "CT",
"PracticeLocationAddressPostalCode": "06510",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "203-688-1010",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "04/19/2012",
"LastUpdateDate": "06/26/2019",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": "M",
"Gender": "Male",
"AuthorizedOfficialLastName": null,
"AuthorizedOfficialFirstName": null,
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": null,
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": null,
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "2085N0700X",
"TaxonomyName": "Neuroradiology Physician",
"LicenseNumber": "295532",
"LicenseNumberStateCode": "NY",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "2085R0202X",
"TaxonomyName": "Diagnostic Radiology Physician",
"LicenseNumber": "295532",
"LicenseNumberStateCode": "NY",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "2085N0700X",
"TaxonomyName": "Neuroradiology Physician",
"LicenseNumber": "63486",
"LicenseNumberStateCode": "CT",
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}