Provider Demographics
NPI:1932197688
Name:PELLEGRINO, ARGENTINO (PHD)
Entity Type:Individual
Prefix:DR
First Name:ARGENTINO
Middle Name:
Last Name:PELLEGRINO
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:332 FOREST GLEN AVE
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN LAKES
Mailing Address - State:NJ
Mailing Address - Zip Code:07417-2419
Mailing Address - Country:US
Mailing Address - Phone:201-725-6655
Mailing Address - Fax:201-934-1800
Practice Address - Street 1:332 FOREST GLEN AVE
Practice Address - Street 2:
Practice Address - City:FRANKLIN LAKES
Practice Address - State:NJ
Practice Address - Zip Code:07417-2419
Practice Address - Country:US
Practice Address - Phone:201-725-6655
Practice Address - Fax:201-934-1800
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-06
Last Update Date:2024-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ35S100177000103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJPE463620Medicare ID - Type Unspecified