Individual
DR. VICTORIA ANNE PETIVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
100 SULLIVAN WAY, WEST TRENTON, NJ 08628
(609) 633-1502
(609) 777-0327
Mailing address
100 SULLIVAN WAY, WEST TRENTON, NJ 08628
(609) 633-1502
(609) 777-0327
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
MA06516700
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7216203
—
NJ
Enumeration date
09/01/2006
Last updated
10/12/2015
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