{
"Npi": {
"NPI": "1932401205",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "CHRISTOPHER JAKUBOWSKI MD LLC",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "244 MAIN ST",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "MERIDEN",
"MailingAddressStateName": "CT",
"MailingAddressPostalCode": "06451-5149",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "203-630-9722",
"MailingAddressFaxNumber": "203-630-9725",
"FirstLinePracticeLocationAddress": "244 MAIN ST",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "MERIDEN",
"PracticeLocationAddressStateName": "CT",
"PracticeLocationAddressPostalCode": "06451-5149",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "203-630-9722",
"PracticeLocationAddressFaxNumber": "203-630-9725",
"EnumerationDate": "11/18/2010",
"LastUpdateDate": "11/18/2010",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "JAKUBOWSKI",
"AuthorizedOfficialFirstName": "KRZYSZTOF",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "OWNER",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "MD",
"AuthorizedOfficialTelephoneNumber": "203-630-9722",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QP2300X",
"TaxonomyName": "Primary Care Clinic/Center",
"LicenseNumber": "036481",
"LicenseNumberStateCode": "CT",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}