{
"Npi": {
"NPI": "1932508991",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "FAMILY PEDIATRIC HOME CARE",
"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": "100 TERRACE AVE",
"SecondLineMailingAddress": "APT 555",
"MailingAddressCityName": "HEMPSTEAD",
"MailingAddressStateName": "NY",
"MailingAddressPostalCode": "11550",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "516-850-0643",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "50 CLINTON STREET",
"SecondLinePracticeLocationAddress": "SUITE 601",
"PracticeLocationAddressCityName": "HEMPSTEAD",
"PracticeLocationAddressStateName": "NY",
"PracticeLocationAddressPostalCode": "11550-2314",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "516-993-0485",
"PracticeLocationAddressFaxNumber": "516-993-1923",
"EnumerationDate": "08/15/2014",
"LastUpdateDate": "08/15/2014",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "KOROMA",
"AuthorizedOfficialFirstName": "KADIATU",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "LPN",
"AuthorizedOfficialNamePrefix": "MS.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "NURSING",
"AuthorizedOfficialTelephoneNumber": "516-850-0643",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "3140N1450X",
"TaxonomyName": "Pediatric Skilled Nursing Facility",
"LicenseNumber": "309696-1",
"LicenseNumberStateCode": "NY",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}