Provider Demographics
NPI:1134735053
Name:DIMAANO, PAMELA PALMA
Entity type:Individual
Prefix:
First Name:PAMELA
Middle Name:PALMA
Last Name:DIMAANO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8047 160TH ST
Mailing Address - Street 2:
Mailing Address - City:JAMAICA
Mailing Address - State:NY
Mailing Address - Zip Code:11432-1107
Mailing Address - Country:US
Mailing Address - Phone:718-380-8874
Mailing Address - Fax:
Practice Address - Street 1:15 W 39TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10018-3806
Practice Address - Country:US
Practice Address - Phone:212-564-6006
Practice Address - Fax:332-205-6207
Is Sole Proprietor?:No
Enumeration Date:2020-09-16
Last Update Date:2020-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health