Provider Demographics
NPI:1538332283
Name:PIMENTEL, ELIZABETH W (ND)
Entity Type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:W
Last Name:PIMENTEL
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:60 LAFAYETTE ST
Mailing Address - Street 2:
Mailing Address - City:BRIDGEPORT
Mailing Address - State:CT
Mailing Address - Zip Code:06604-5719
Mailing Address - Country:US
Mailing Address - Phone:203-576-4349
Mailing Address - Fax:
Practice Address - Street 1:60 LAFAYETTE ST
Practice Address - Street 2:
Practice Address - City:BRIDGEPORT
Practice Address - State:CT
Practice Address - Zip Code:06604-5719
Practice Address - Country:US
Practice Address - Phone:203-576-4349
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-04-02
Last Update Date:2017-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000372175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath