Active NPI
Sandra Pimentel, PHD
- Clinical Child & Adolescent Psychologist
- New York, NY
National Provider Identifier
1205168705
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Child & Adolescent Psychologist
- License
- 018301-1
- Practice address
- 1775 Broadway, Cucard
Suite 601
New York, NY 10019 - Phone
- (212) 246-5022
- NPI assigned
- Feb 8, 2010
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Child & Adolescent Psychologist | 103TC2200X | 018301-1 | NY | Primary |
Addresses
Primary practice location
1775 Broadway, Cucard
Suite 601
New York, NY 10019
Mailing address
1775 Broadway
Suite 601
New York, NY 10019
Phone (212) 246-5022
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 018301-1 | NY | MD | Clinical Child & Adolescent Psychologist |
Networks
- Healthfirst Medicare Network H1722
- Healthfirst Medicare Network H9678
- Healthfirst Medicare Network H3359
- Healthfirst Medicare Network H5989
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1265587200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1265587200000",
"number": "1205168705",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1775 BROADWAY",
"address_2": "SUITE 601",
"city": "NEW YORK",
"state": "NY",
"postal_code": "10019",
"telephone_number": "212-246-5022"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1775 BROADWAY, CUCARD",
"address_2": "SUITE 601",
"city": "NEW YORK",
"state": "NY",
"postal_code": "10019",
"telephone_number": "212-246-5022"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PIMENTEL",
"first_name": "SANDRA",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-02-08",
"last_updated": "2010-02-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TC2200X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical Child & Adolescent",
"state": "NY",
"license": "018301-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.