Petino, Damian

Petino, Damian is an sole proprietor health care provider with primary practice located at 200 Valley Rd Ste 104 , Mt Arlington NJ 07856-1320. He recently has only one registered license in Behavioral Health & Social Service Providers / Psychologist, which is considered as his primary health care specialty. Petino, Damian can be contacted via phone (732) 841-5847.

Contact Information

Primary practice address
200 Valley Rd Ste 104 Mt Arlington NJ 07856-1320
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Psychologist 103T00000X 35SI00545300 New Jersey

Profile Details

NPI number 1801301981
LBN Legal business name Petino, Damian
Credentials PSY.D.
Entity Individual
Sole proprietor 1 Yes
Enumeration date Dec 11th, 2017
Last updated Dec 11th, 2017 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1801301981 NPPES
New Jersey Other 35SI00545300 NJ DIVISION OF CONSUMER AFFAIRS - PSYCHOLOGY LICENSE

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