Individual
EDGAR ANDREW PIMENTEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
570 W 204TH ST, NEW YORK, NY 10034-4008
(212) 567-3777
Mailing address
143 REVILLE ST, BRONX, NY 10464-1339
Taxonomy
Speciality
Code
Description
License number
State
207QG0300X
Geriatric Medicine (Family Medicine) Physician
Primary
203059
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01688513
—
NY
Enumeration date
09/28/2006
Last updated
07/01/2008
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