{
"Npi": {
"NPI": "1962455006",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "VALCOUR IMAGING LLC",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "16 DEGRANDPRE WAY",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "PLATTSBURGH",
"MailingAddressStateName": "NY",
"MailingAddressPostalCode": "12901-6451",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "518-563-1900",
"MailingAddressFaxNumber": "518-563-2600",
"FirstLinePracticeLocationAddress": "16 DEGRANDPRE WAY",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "PLATTSBURGH",
"PracticeLocationAddressStateName": "NY",
"PracticeLocationAddressPostalCode": "12901-6451",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "518-563-1900",
"PracticeLocationAddressFaxNumber": "518-563-2600",
"EnumerationDate": "05/18/2006",
"LastUpdateDate": "10/15/2007",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "BULA",
"AuthorizedOfficialFirstName": "WOLODYMYR",
"AuthorizedOfficialMiddleName": "I",
"AuthorizedOfficialTitle": "MANAGING PARTNER",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "MD",
"AuthorizedOfficialTelephoneNumber": "518-563-1900",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QR0200X",
"TaxonomyName": "Radiology Clinic/Center",
"LicenseNumber": "0901204R",
"LicenseNumberStateCode": "NY",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}