{
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"IsOrgSubpart": "N",
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"ParentOrgTIN": null,
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"LastName": null,
"FirstName": null,
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"NamePrefix": null,
"NameSuffix": null,
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"FirstLineMailingAddress": "1732 E RIDGE RD",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "ROCHESTER",
"MailingAddressStateName": "NY",
"MailingAddressPostalCode": "14622-2157",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "585-266-2782",
"MailingAddressFaxNumber": "585-266-2785",
"FirstLinePracticeLocationAddress": "1732 E RIDGE RD",
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"PracticeLocationAddressCityName": "ROCHESTER",
"PracticeLocationAddressStateName": "NY",
"PracticeLocationAddressPostalCode": "14622-2157",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "585-266-2782",
"PracticeLocationAddressFaxNumber": "585-266-2785",
"EnumerationDate": "03/07/2012",
"LastUpdateDate": "03/07/2012",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "DIAZ-VEGA",
"AuthorizedOfficialFirstName": "YASELLYN",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "CHIROPRACTOR",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "DC",
"AuthorizedOfficialTelephoneNumber": "585-266-2782",
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "111N00000X",
"TaxonomyName": "Chiropractor",
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"LicenseNumberStateCode": "NY",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "111N00000X",
"TaxonomyName": "Chiropractor",
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}
]
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": [
{
"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."
}
]
}
}
}