{
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"EIN": null,
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"LastName": "DENNIS",
"FirstName": "SUSAN",
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"Credential": "LMT",
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"FirstLineMailingAddress": "2930 STATE ROUTE 49",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "BLOSSVALE",
"MailingAddressStateName": "NY",
"MailingAddressPostalCode": "13308-3129",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": null,
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "1104 MAIN ST",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "SYLVAN BEACH",
"PracticeLocationAddressStateName": "NY",
"PracticeLocationAddressPostalCode": "13157-7786",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "315-371-7701",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "08/03/2018",
"LastUpdateDate": "08/03/2018",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": "F",
"Gender": "Female",
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"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "225700000X",
"TaxonomyName": "Massage Therapist",
"LicenseNumber": "028572-1",
"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."
}
}
}
}