{
"Npi": {
"NPI": "1902525306",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "CARUSO",
"FirstName": "MOLLY",
"MiddleName": "ANN",
"NamePrefix": null,
"NameSuffix": null,
"Credential": "PA-C",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "LACASSE",
"OtherFirstName": "MOLLY",
"OtherMiddleName": "ANN",
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": "PA-C",
"OtherLastNameTypeCode": "1",
"FirstLineMailingAddress": "360 US HIGHWAY 1 BYP UNIT 102",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "PORTSMOUTH",
"MailingAddressStateName": "NH",
"MailingAddressPostalCode": "03801-7105",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "603-410-6700",
"MailingAddressFaxNumber": "603-319-8308",
"FirstLinePracticeLocationAddress": "8 LOUDON RD",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "CONCORD",
"PracticeLocationAddressStateName": "NH",
"PracticeLocationAddressPostalCode": "03301-5300",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "603-226-9000",
"PracticeLocationAddressFaxNumber": "603-226-2268",
"EnumerationDate": "08/26/2022",
"LastUpdateDate": "07/25/2024",
"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": "363A00000X",
"TaxonomyName": "Physician Assistant",
"LicenseNumber": "2021",
"LicenseNumberStateCode": "NH",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}