{
"Npi": {
"NPI": "1952721847",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "ST PETER PHARMACY",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": "6",
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "15-17 ROPES PL",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "NEWARK",
"MailingAddressStateName": "NJ",
"MailingAddressPostalCode": "07107-4803",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "862-240-9311",
"MailingAddressFaxNumber": "862-240-9310",
"FirstLinePracticeLocationAddress": "15-17 ROPES PL",
"SecondLinePracticeLocationAddress": "#106",
"PracticeLocationAddressCityName": "NEWARK",
"PracticeLocationAddressStateName": "NJ",
"PracticeLocationAddressPostalCode": "07107-4803",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "862-240-9311",
"PracticeLocationAddressFaxNumber": "862-240-9310",
"EnumerationDate": "04/18/2014",
"LastUpdateDate": "05/13/2020",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "MASSAK",
"AuthorizedOfficialFirstName": "PETER",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "MEMBER",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "862-240-9311",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "3336C0003X",
"TaxonomyName": "Community/Retail Pharmacy",
"LicenseNumber": "28RS00732800",
"LicenseNumberStateCode": "NJ",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}