{
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"EIN": null,
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"IsOrgSubpart": "N",
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"FirstLineMailingAddress": "101 ROUTE 130 S- PRESIDENTIAL CENTER",
"SecondLineMailingAddress": "WASHINGTON BLDG SUITE 10",
"MailingAddressCityName": "CINNAMINSON",
"MailingAddressStateName": "NJ",
"MailingAddressPostalCode": "08077",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": null,
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "101 ROUTE 130 S- PRESIDENTIAL CENTER",
"SecondLinePracticeLocationAddress": "WASHINGTON BLDG SUITE 10",
"PracticeLocationAddressCityName": "CINNAMINSON",
"PracticeLocationAddressStateName": "NJ",
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"PracticeLocationAddressTelephoneNumber": "609-346-2954",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "08/09/2018",
"LastUpdateDate": "08/09/2018",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "HARDY",
"AuthorizedOfficialFirstName": "DANE",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "CHIROPRACTOR/OWNER",
"AuthorizedOfficialNamePrefix": "DR.",
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"AuthorizedOfficialCredential": "DC",
"AuthorizedOfficialTelephoneNumber": "609-346-2954",
"Taxonomies": {
"Taxonomy": {
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"TaxonomyName": "Chiropractor",
"LicenseNumber": "38MC00738000",
"LicenseNumberStateCode": "NJ",
"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."
}
}
}
}