{
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"ParentOrgTIN": null,
"OrgName": "ROME HEARING CLINIC",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
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"FirstLineMailingAddress": "624 BLACK RIVER BLVD N",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "ROME",
"MailingAddressStateName": "NY",
"MailingAddressPostalCode": "13440-4326",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "315-336-7250",
"MailingAddressFaxNumber": "315-336-7254",
"FirstLinePracticeLocationAddress": "624 BLACK RIVER BLVD N",
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"PracticeLocationAddressCityName": "ROME",
"PracticeLocationAddressStateName": "NY",
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"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "315-336-7250",
"PracticeLocationAddressFaxNumber": "315-336-7254",
"EnumerationDate": "08/29/2007",
"LastUpdateDate": "08/29/2007",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "MIDDLEBY",
"AuthorizedOfficialFirstName": "MARIA",
"AuthorizedOfficialMiddleName": "THERESA",
"AuthorizedOfficialTitle": "AUDIOLOGIST/OWNER",
"AuthorizedOfficialNamePrefix": "MRS.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "MS-CCC-A",
"AuthorizedOfficialTelephoneNumber": "315-336-7250",
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "237600000X",
"TaxonomyName": "Audiologist-Hearing Aid Fitter",
"LicenseNumber": "984",
"LicenseNumberStateCode": "NY",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "237600000X",
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}
]
},
"HealthcareProviderTaxonomyGroups": {
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{
"HealthcareProviderTaxonomyGroupName": "193400000X MULTIPLE 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."
},
{
"HealthcareProviderTaxonomyGroupName": "193400000X MULTIPLE 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."
}
]
}
}
}