Individual provider Active NPI

Barbara Elena Petrella, PH.D.

  • Psychologist
  • Wyckoff, NJ
National Provider Identifier
1063358869
Registry record updated Apr 25, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
35SI100517100 Issued in NJ
Practice address
239 Madison Ave
Wyckoff, NJ 07481-1948
Phone
(917) 690-5209
NPI assigned
Apr 25, 2026
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 25, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 015654 NY
Psychologist 103T00000X PY6903 FL
PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103T00000X 35SI100517100 NJ Primary

Addresses

Primary practice location

239 Madison Ave
Wyckoff, NJ 07481-1948

Mailing address

239 Madison Ave
Wyckoff, NJ 07481-1948
Phone (917) 690-5209

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PY6903FLMDPsychologist
35SI100517100NJMDPsychologist
015654NYMDPsychologist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1777075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777075200000",
    "number": "1063358869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "239 MADISON AVE",
            "city": "WYCKOFF",
            "state": "NJ",
            "postal_code": "074811948",
            "telephone_number": "917-690-5209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "239 MADISON AVE",
            "city": "WYCKOFF",
            "state": "NJ",
            "postal_code": "074811948",
            "telephone_number": "917-690-5209"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETRELLA",
        "first_name": "BARBARA",
        "middle_name": "ELENA",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-04-25",
        "last_updated": "2026-04-25",
        "certification_date": "2026-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NY",
            "license": "015654",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "FL",
            "license": "PY6903",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": "NJ",
            "license": "35SI100517100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wyckoff, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.