Healthcare Provider Details

I. General information

NPI: 1568873917
Provider Name (Legal Business Name): MICHELLE ZAPATA PIMENTEL M.A. SP ED
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/19/2014
Last Update Date: 05/19/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

29 ELINOR PL APT 2
YONKERS NY
10705-8801
US

IV. Provider business mailing address

29 ELINOR PL APT 2
YONKERS NY
10705-8801
US

V. Phone/Fax

Practice location:
  • Phone: 201-926-0445
  • Fax:
Mailing address:
  • Phone: 201-926-0445
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number1157409
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: