Provider Demographics
NPI:1184073470
Name:NYC HOLISTIC
Entity type:Organization
Organization Name:NYC HOLISTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:SASHA
Authorized Official - Middle Name:
Authorized Official - Last Name:PIMIENTA
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:347-878-9138
Mailing Address - Street 1:336 CANAL ST APT 4E
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10013-2588
Mailing Address - Country:US
Mailing Address - Phone:347-878-9138
Mailing Address - Fax:
Practice Address - Street 1:149 MADISON AVE STE 1118
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-6713
Practice Address - Country:US
Practice Address - Phone:347-878-9138
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-07
Last Update Date:2016-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY021214-1251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health