{
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"FirstLineMailingAddress": "PO BOX 606",
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"MailingAddressCityName": "PLAINSBORO",
"MailingAddressStateName": "NJ",
"MailingAddressPostalCode": "08536-0606",
"MailingAddressCountryCode": "US",
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"FirstLinePracticeLocationAddress": "21 LINWOOD DR",
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"PracticeLocationAddressCityName": "MONROE TOWNSHIP",
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"EnumerationDate": "06/29/2018",
"LastUpdateDate": "06/29/2018",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "SANTOS",
"AuthorizedOfficialFirstName": "MELODY",
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"AuthorizedOfficialTitle": "MEMBER",
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"AuthorizedOfficialCredential": "PT",
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"Taxonomies": {
"Taxonomy": {
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"TaxonomyName": "Physical Therapist",
"LicenseNumber": "PT40QA00712500",
"LicenseNumberStateCode": "NJ",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
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"HealthcareProviderTaxonomyGroupName": "193400000X 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."
}
}
}
}