Provider Demographics
NPI:1528516663
Name:PIMENTEL, ANA MARIA (DPM)
Entity type:Individual
Prefix:DR
First Name:ANA
Middle Name:MARIA
Last Name:PIMENTEL
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:ANA
Other - Middle Name:MARIA
Other - Last Name:PIMENTEL-TEJEDA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:25 PROSPECT AVE
Mailing Address - Street 2:
Mailing Address - City:HACKENSACK
Mailing Address - State:NJ
Mailing Address - Zip Code:07601-1960
Mailing Address - Country:US
Mailing Address - Phone:201-343-2277
Mailing Address - Fax:201-343-7410
Practice Address - Street 1:25 PROSPECT AVE
Practice Address - Street 2:
Practice Address - City:HACKENSACK
Practice Address - State:NJ
Practice Address - Zip Code:07601-1960
Practice Address - Country:US
Practice Address - Phone:201-343-2277
Practice Address - Fax:201-343-7410
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-19
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MD00333000213EP1101X, 213ES0103X, 213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
No213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric Medicine
No213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery