Healthcare Provider Details

I. General information

NPI: 1073445284
Provider Name (Legal Business Name): NORAIMA R PIMENTEL DIAZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/01/2026
Last Update Date: 06/01/2026
Certification Date: 06/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7010 96TH PL
LANHAM MD
20706-3620
US

IV. Provider business mailing address

7010 96TH PL
LANHAM MD
20706-3620
US

V. Phone/Fax

Practice location:
  • Phone: 240-476-1337
  • Fax:
Mailing address:
  • Phone: 240-476-1337
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number0732012102
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: