Healthcare Provider Details

I. General information

NPI: 1154122216
Provider Name (Legal Business Name): LILIBETH PIMENTEL FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/24/2025
Last Update Date: 12/11/2025
Certification Date: 12/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

95 GREENE ST
JERSEY CITY NJ
07302-3815
US

IV. Provider business mailing address

95 GREENE ST
JERSEY CITY NJ
07302-3815
US

V. Phone/Fax

Practice location:
  • Phone: 201-499-8730
  • Fax: 609-991-6342
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number26NJ15360400
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN2339886
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: