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General NPI Number Information
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NPI Number | 1154862001
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Entity Type | Organization
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Legal Business Name | KERI PETRONE, PSY.D., LLC
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Dates
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Enumeration Date | 03/11/2017
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Last Update Date | 01/22/2021
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Provider Practice Location Address
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Address Line | 130 ABERDEEN RD APT 24
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City | MATAWAN
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State | NJ
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Zip | 07747-1171
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Country | US
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Telephone | 732-266-5114
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Fax |
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Provider Business Mailing Address
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Address Line | 130 ABERDEEN RD APT 24
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City | MATAWAN
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State | NJ
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Zip | 07747-1171
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Country | US
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Telephone | 732-266-5114
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Fax |
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Authorized Official
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Title or Position | OWNER, CLINICAL PSYCHOLOGIST
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Name | DR. KERI PETRONE
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Credential | PSYD
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Telephone | 732-266-5114
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 5634
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License Number State | NJ
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