{
"Npi": {
"NPI": "1942501549",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "DAHER",
"FirstName": "NICOLE",
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": "PHYSICIAN ASSISTANT",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "300 W ELM ST",
"SecondLineMailingAddress": "STE 2321",
"MailingAddressCityName": "CONSHOHOCKEN",
"MailingAddressStateName": "PA",
"MailingAddressPostalCode": "19428-1807",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "215-479-1610",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "300 W ELM ST",
"SecondLinePracticeLocationAddress": "STE 2321",
"PracticeLocationAddressCityName": "CONSHOHOCKEN",
"PracticeLocationAddressStateName": "PA",
"PracticeLocationAddressPostalCode": "19428-1807",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "215-479-1610",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "11/12/2010",
"LastUpdateDate": "07/10/2014",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": "F",
"Gender": "Female",
"AuthorizedOfficialLastName": null,
"AuthorizedOfficialFirstName": null,
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": null,
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": null,
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "363A00000X",
"TaxonomyName": "Physician Assistant",
"LicenseNumber": "014395",
"LicenseNumberStateCode": "NY",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "363AM0700X",
"TaxonomyName": "Medical Physician Assistant",
"LicenseNumber": "MA054527",
"LicenseNumberStateCode": "PA",
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}