{
"Npi": {
"NPI": "1992450746",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "Y",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "SZWANDRAK",
"FirstName": "TARA",
"MiddleName": "NANCY",
"NamePrefix": null,
"NameSuffix": null,
"Credential": "PT",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "44 SHIELDS AVE",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "FLEMINGTON",
"MailingAddressStateName": "NJ",
"MailingAddressPostalCode": "08822-1378",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "908-892-8143",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "3 WALTER E FORAN BLVD.",
"SecondLinePracticeLocationAddress": "SUITE 305",
"PracticeLocationAddressCityName": "FLEMINGTON",
"PracticeLocationAddressStateName": "NJ",
"PracticeLocationAddressPostalCode": "08822",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "908-892-8895",
"PracticeLocationAddressFaxNumber": "908-782-4765",
"EnumerationDate": "02/18/2022",
"LastUpdateDate": "01/25/2023",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": "F",
"Gender": "Female",
"AuthorizedOfficialLastName": null,
"AuthorizedOfficialFirstName": null,
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": null,
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": null,
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "225100000X",
"TaxonomyName": "Physical Therapist",
"LicenseNumber": "40QA01023400",
"LicenseNumberStateCode": "NJ",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}