{
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"OtherLastName": "EGEGBARA",
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"FirstLineMailingAddress": "307 W 38TH STREET",
"SecondLineMailingAddress": "16TH FLR #465",
"MailingAddressCityName": "NEW YORK",
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"FirstLinePracticeLocationAddress": "37 W 26TH ST RM 200",
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"PracticeLocationAddressCityName": "NEW YORK",
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"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "212-368-3038",
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"EnumerationDate": "04/20/2026",
"LastUpdateDate": "04/20/2026",
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"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": "F",
"Gender": "Female",
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"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "225700000X",
"TaxonomyName": "Massage Therapist",
"LicenseNumber": "029931",
"LicenseNumberStateCode": "NY",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"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."
}
}
}
}