Provider Demographics
NPI:1760628531
Name:PINEDA, ROSA YOLANDA (PSY D)
Entity Type:Individual
Prefix:DR
First Name:ROSA
Middle Name:YOLANDA
Last Name:PINEDA
Suffix:
Gender:F
Credentials:PSY D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:555 W 186TH ST APT 4C
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10033-2736
Mailing Address - Country:US
Mailing Address - Phone:646-225-0300
Mailing Address - Fax:
Practice Address - Street 1:18 SUNNY RIDGE RD
Practice Address - Street 2:
Practice Address - City:SPRING VALLEY
Practice Address - State:NY
Practice Address - Zip Code:10977
Practice Address - Country:US
Practice Address - Phone:212-356-3869
Practice Address - Fax:917-339-1765
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-30
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator