{
"Npi": {
"NPI": "1962795716",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "NEW HOPE: PHYSICAL SPEECH OCCUPATIONAL AND LMSW SERVICES PLLC",
"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": "7 FENWICK ST",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "GREENLAWN",
"MailingAddressStateName": "NY",
"MailingAddressPostalCode": "11740-1405",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "631-757-4063",
"MailingAddressFaxNumber": "631-757-4063",
"FirstLinePracticeLocationAddress": "27 CATHERINE ST",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "EAST NORTHPORT",
"PracticeLocationAddressStateName": "NY",
"PracticeLocationAddressPostalCode": "11731-1318",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "631-261-9145",
"PracticeLocationAddressFaxNumber": "631-262-9145",
"EnumerationDate": "05/25/2011",
"LastUpdateDate": "05/25/2011",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "CEPEDA AMANTIA",
"AuthorizedOfficialFirstName": "DIANE",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "SECRETARY/TREASURER MGR MBR",
"AuthorizedOfficialNamePrefix": "MS.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "P.T.",
"AuthorizedOfficialTelephoneNumber": "631-757-4063",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "252Y00000X",
"TaxonomyName": "Early Intervention Provider Agency",
"LicenseNumber": "0111231",
"LicenseNumberStateCode": "NY",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}