{
"Npi": {
"NPI": "1952354656",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "SCLESKY",
"FirstName": "AMY",
"MiddleName": "L.",
"NamePrefix": "MRS.",
"NameSuffix": null,
"Credential": "PA-C",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "GALPIN",
"OtherFirstName": "AMY",
"OtherMiddleName": "L.",
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": "P.A.",
"OtherLastNameTypeCode": "1",
"FirstLineMailingAddress": "133 PARK ST",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "MALONE",
"MailingAddressStateName": "NY",
"MailingAddressPostalCode": "12953-1244",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "518-481-2790",
"MailingAddressFaxNumber": "518-481-2788",
"FirstLinePracticeLocationAddress": "187 PARK ST",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "MALONE",
"PracticeLocationAddressStateName": "NY",
"PracticeLocationAddressPostalCode": "12953-1233",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "518-481-2896",
"PracticeLocationAddressFaxNumber": "518-481-2788",
"EnumerationDate": "05/17/2006",
"LastUpdateDate": "07/21/2022",
"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": "1501025",
"LicenseNumberStateCode": "KS",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "363A00000X",
"TaxonomyName": "Physician Assistant",
"LicenseNumber": "MA053692",
"LicenseNumberStateCode": "PA",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "363A00000X",
"TaxonomyName": "Physician Assistant",
"LicenseNumber": "020534",
"LicenseNumberStateCode": "NY",
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}