{
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"EIN": null,
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"IsOrgSubpart": "N",
"ParentOrgLBN": null,
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"OrgName": "SEA CLIFF CHIROPRACTIC PC",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
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"OtherLastName": null,
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"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "6369 MILL ST",
"SecondLineMailingAddress": "SUITE 101",
"MailingAddressCityName": "RHINEBECK",
"MailingAddressStateName": "NY",
"MailingAddressPostalCode": "12572-1406",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "516-316-4589",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "6369 MILL ST",
"SecondLinePracticeLocationAddress": "SUITE 101",
"PracticeLocationAddressCityName": "RHINEBECK",
"PracticeLocationAddressStateName": "NY",
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"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "516-316-4589",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "08/23/2011",
"LastUpdateDate": "04/15/2016",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "CHARNO",
"AuthorizedOfficialFirstName": "RUSSELL",
"AuthorizedOfficialMiddleName": "MARC",
"AuthorizedOfficialTitle": "OWNER",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "D.C.",
"AuthorizedOfficialTelephoneNumber": "516-316-4589",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261Q00000X",
"TaxonomyName": "Clinic/Center",
"LicenseNumber": "X0052491",
"LicenseNumberStateCode": "NY",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}