{
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"FirstLineMailingAddress": "4 QUINE ST",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "CRANFORD",
"MailingAddressStateName": "NJ",
"MailingAddressPostalCode": "07016-3130",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "908-499-3956",
"MailingAddressFaxNumber": "908-276-8765",
"FirstLinePracticeLocationAddress": "379 MAIN AVE STE 3",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "WALLINGTON",
"PracticeLocationAddressStateName": "NJ",
"PracticeLocationAddressPostalCode": "07057-1829",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "201-655-6617",
"PracticeLocationAddressFaxNumber": "201-655-6618",
"EnumerationDate": "11/02/2020",
"LastUpdateDate": "11/02/2020",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "KLIMEK",
"AuthorizedOfficialFirstName": "CHESTER",
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"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "DPM",
"AuthorizedOfficialTelephoneNumber": "908-873-8171",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "213ES0103X",
"TaxonomyName": "Foot & Ankle Surgery Podiatrist",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"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."
}
}
}
}