Individual
DR. DAMIAN PETINO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PSY.D.
Contact information
Practice address
200 VALLEY RD STE 104, MT ARLINGTON, NJ 07856-1320
(732) 841-5847
Mailing address
420 ROCK RIDGE RD, LAKE HOPATCONG, NJ 07849-2468
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
35SI00545300
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
35SI00545300
NJ DIVISION OF CONSUMER AFFAIRS - PSYCHOLOGY LICENSE
NJ
Enumeration date
12/11/2017
Last updated
12/11/2017
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