{
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"FirstLineMailingAddress": "87 GRANDVIEW AVE STE B",
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"MailingAddressTelephoneNumber": "203-465-1424",
"MailingAddressFaxNumber": "203-465-1481",
"FirstLinePracticeLocationAddress": "43 YAWPO AVE STE 1",
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"EnumerationDate": "11/12/2025",
"LastUpdateDate": "11/12/2025",
"NPIDeactivationReasonCode": null,
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"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "SOLL",
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"Taxonomies": {
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"LicenseNumber": null,
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"PrimaryTaxonomySwitch": "Y"
}
},
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}
}