| Keri Petrone, Psy.d., Llc | |
|
130 Aberdeen Rd Apt 24 Matawan NJ 07747-1171 | |
| (732) 266-5114 | |
| Not Available |
| Full Name | Keri Petrone, Psy.d., Llc |
|---|---|
| Speciality | Psychologist |
| Location | 130 Aberdeen Rd Apt 24, Matawan, New Jersey |
| Authorized Official Name and Position | Keri Petrone (OWNER, CLINICAL PSYCHOLOGIST) |
| Authorized Official Contact | 7322665114 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Keri Petrone, Psy.d., Llc 130 Aberdeen Rd Apt 24 Matawan NJ 07747-1171 Ph: (732) 266-5114 | Keri Petrone, Psy.d., Llc 130 Aberdeen Rd Apt 24 Matawan NJ 07747-1171 Ph: (732) 266-5114 |
| NPI Number | 1154862001 |
|---|---|
| Provider Enumeration Date | 03/11/2017 |
| Last Update Date | 01/22/2021 |
| Certification Date | 01/22/2021 |
| Medicare PECOS PAC ID | 9931477841 |
|---|---|
| Medicare Enrollment ID | O20170619001041 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154862001 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 5634 (New Jersey) | Primary |
| Provider Name | Keri Petrone |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1720536451 PECOS PAC ID: 2668753534 Enrollment ID: I20170109000884 |
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