MEDICARE: BRAULIO PIMENTEL

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1508343377
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRAULIO PIMENTEL

Provider Business Mailing Address
First Line	:	1326 RIVERSIDE DR APT 51
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10033-1013
Country	:	US
Telephone Number	:	714-653-8910
Fax Number	:

Provider Business Practice Location Address
First Line	:	1326 RIVERSIDE DR APT 51
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10033-1013
Country	:	US
Telephone Number	:	714-653-8910
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/25/2018
Last Update Date	:	01/31/2022

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Directions to “ BRAULIO PIMENTEL ” Practice Location

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