Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0210X | Pediatric Nephrologist | 167505 | NY |
NPI | 1780756361 |
---|---|
Provider Name | Dr. Consolacion Tanedo Pimentel |
First Address | Bronx, NY 10451-5504 |
Second Address | West Nyack, NY 10994-1236 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/11/2006 |
Last Update Date | 08/07/2007 |