Healthcare Provider Details

I. General information

NPI: 1033038013
Provider Name (Legal Business Name): DR. URIJAH REIGNE PIMENTEL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/13/2026
Last Update Date: 07/13/2026
Certification Date: 07/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4106 BROADWAY
ASTORIA NY
11103-3288
US

IV. Provider business mailing address

5703 84TH ST APT 1
ELMHURST NY
11373-4823
US

V. Phone/Fax

Practice location:
  • Phone: 347-448-6212
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number074193
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: