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General NPI Number Information
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NPI Number | 1114302908
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Entity Type | Individual
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Provider Name | DR. SASHA PIMIENTA
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Gender | Female
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Dates
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Enumeration Date | 07/22/2015
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Last Update Date | 08/13/2021
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Provider Practice Location Address
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Address Line | 149 MADISON AVE STE 1118
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City | NEW YORK
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State | NY
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Zip | 10016-6713
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Country | US
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Telephone | 347-878-9138
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Fax |
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Provider Business Mailing Address
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Address Line | 336 CANAL ST APT 4E
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City | NEW YORK
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State | NY
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Zip | 10013-2588
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Country | US
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Telephone | 312-532-8550
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 021214-1
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License Number State | NY
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