Provider Demographics
NPI:1356464812
Name:DAMIANI, DINO (RPH)
Entity Type:Individual
Prefix:MR
First Name:DINO
Middle Name:
Last Name:DAMIANI
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:584 HILLSBOROUGH RD
Mailing Address - Street 2:
Mailing Address - City:HILLSBOROUGH
Mailing Address - State:NJ
Mailing Address - Zip Code:08844-2908
Mailing Address - Country:US
Mailing Address - Phone:908-227-2629
Mailing Address - Fax:718-667-2344
Practice Address - Street 1:584 HILLSBOROUGH RD
Practice Address - Street 2:
Practice Address - City:HILLSBOROUGH
Practice Address - State:NJ
Practice Address - Zip Code:08844-2908
Practice Address - Country:US
Practice Address - Phone:908-227-2629
Practice Address - Fax:718-667-2542
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-09
Last Update Date:2013-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY337091835P1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1300XPharmacy Service ProvidersPharmacistPsychiatric