{
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"EIN": null,
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"IsOrgSubpart": "N",
"ParentOrgLBN": null,
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"OrgName": "NANCY C. DEACON, PSYCHIATRIC NURSE PRACTITIONER, P.C.",
"LastName": null,
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"NamePrefix": null,
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"FirstLineMailingAddress": "150 BROADHOLLOW RD",
"SecondLineMailingAddress": "SUITE 310",
"MailingAddressCityName": "MELVILLE",
"MailingAddressStateName": "NY",
"MailingAddressPostalCode": "11747-4905",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "631-636-7050",
"MailingAddressFaxNumber": "631-549-1097",
"FirstLinePracticeLocationAddress": "80 SALEM RIDGE DR",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "HUNTINGTON",
"PracticeLocationAddressStateName": "NY",
"PracticeLocationAddressPostalCode": "11743-3015",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "631-495-7762",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "07/23/2015",
"LastUpdateDate": "07/23/2015",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "DEACON",
"AuthorizedOfficialFirstName": "NANCY",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "PRESIDENT",
"AuthorizedOfficialNamePrefix": "MRS.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "631-495-7762",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "363LP0808X",
"TaxonomyName": "Psychiatric/Mental Health Nurse Practitioner",
"LicenseNumber": "F401406-1",
"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."
}
}
}
}