Provider Demographics
NPI:1699836932
Name:PELLEGRINO, MARISSA NICOLE (PHD)
Entity Type:Individual
Prefix:DR
First Name:MARISSA
Middle Name:NICOLE
Last Name:PELLEGRINO
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:MARISSA
Other - Middle Name:NICOLE
Other - Last Name:CAFARELLA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:45 W SHORE DR
Mailing Address - Street 2:
Mailing Address - City:PENNINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08534-2122
Mailing Address - Country:US
Mailing Address - Phone:609-737-6896
Mailing Address - Fax:
Practice Address - Street 1:100 CANAL POINTE BLVD STE 210
Practice Address - Street 2:
Practice Address - City:PRINCETON
Practice Address - State:NJ
Practice Address - Zip Code:08540-7169
Practice Address - Country:US
Practice Address - Phone:609-895-1070
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-12
Last Update Date:2023-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist