{
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"OrgName": "NEW YORK NEUROSURGERY & NEUROSCIENCE ASSOCIATES",
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"FirstLineMailingAddress": "2000 N VILLAGE AVE",
"SecondLineMailingAddress": "STE 403",
"MailingAddressCityName": "ROCKVILLE CENTER",
"MailingAddressStateName": "NY",
"MailingAddressPostalCode": "11570-1078",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "516-255-0350",
"MailingAddressFaxNumber": "516-678-1421",
"FirstLinePracticeLocationAddress": "110 OCEAN BLVD",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "POINT LOOKOUT",
"PracticeLocationAddressStateName": "NY",
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"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "516-255-0350",
"PracticeLocationAddressFaxNumber": "516-738-4746",
"EnumerationDate": "05/10/2006",
"LastUpdateDate": "07/10/2020",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "CORNACCHIA",
"AuthorizedOfficialFirstName": "LOUIS",
"AuthorizedOfficialMiddleName": "G",
"AuthorizedOfficialTitle": "NEUROSURGEON, DIRECTOR",
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"AuthorizedOfficialNameSuffix": "III",
"AuthorizedOfficialCredential": "MD",
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"Taxonomies": {
"Taxonomy": {
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"TaxonomyName": "Specialist",
"LicenseNumber": "007844-1",
"LicenseNumberStateCode": "NY",
"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."
}
}
}
}