{
"Npi": {
"NPI": "1932519410",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "SZELES",
"FirstName": "ALEXANDER",
"MiddleName": "RICHARD",
"NamePrefix": "DR.",
"NameSuffix": "II",
"Credential": "DO",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "4700 UNION DEPOSIT RD",
"SecondLineMailingAddress": "STE 220",
"MailingAddressCityName": "HARRISBURG",
"MailingAddressStateName": "PA",
"MailingAddressPostalCode": "17111-3774",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "717-695-6326",
"MailingAddressFaxNumber": "717-695-6908",
"FirstLinePracticeLocationAddress": "4700 UNION DEPOSIT RD",
"SecondLinePracticeLocationAddress": "STE 220",
"PracticeLocationAddressCityName": "HARRISBURG",
"PracticeLocationAddressStateName": "PA",
"PracticeLocationAddressPostalCode": "17111-3774",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "717-695-6326",
"PracticeLocationAddressFaxNumber": "717-695-6908",
"EnumerationDate": "05/05/2014",
"LastUpdateDate": "10/11/2019",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": "M",
"Gender": "Male",
"AuthorizedOfficialLastName": null,
"AuthorizedOfficialFirstName": null,
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": null,
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": null,
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "207W00000X",
"TaxonomyName": "Ophthalmology Physician",
"LicenseNumber": "OT015751",
"LicenseNumberStateCode": "PA",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "207W00000X",
"TaxonomyName": "Ophthalmology Physician",
"LicenseNumber": "5101021782",
"LicenseNumberStateCode": "MI",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "207W00000X",
"TaxonomyName": "Ophthalmology Physician",
"LicenseNumber": "OS019294",
"LicenseNumberStateCode": "PA",
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}