Individual provider Active NPI

Angela Raghib, PSYD

  • Student in an Organized Health Care Education/Training Program
  • Tinton Falls, NJ
National Provider Identifier
1124840947
Registry record updated Jun 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
License
253-017 Issued in NJ
Practice address
4000 Route 66 Ste 331
Tinton Falls, NJ 07753-7300
Phone
(732) 988-3441
NPI assigned
Oct 31, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 253-017 NJ Primary

Addresses

Primary practice location

4000 Route 66 Ste 331
Tinton Falls, NJ 07753-7300

Mailing address

107 W 82ND St
New York, NY 10024-5511

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

State licenses

LicenseStateTypeSpecialty
253-017NJMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Comprehensive Psychology System PC Psychologist CurrentSince Jun 29, 2025 Accepting new patients

Locations

4000 State Route 66
Ste 331
Tinton Falls, NJ 07753
Phone (732) 922-0634

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1730332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750723200000",
    "number": "1124840947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 W 82ND ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100245511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4000 ROUTE 66 STE 331",
            "city": "TINTON FALLS",
            "state": "NJ",
            "postal_code": "077537300",
            "telephone_number": "732-988-3441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAGHIB",
        "first_name": "ANGELA",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-10-31",
        "last_updated": "2025-06-24",
        "certification_date": "2025-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NJ",
            "license": "253-017",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tinton Falls, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2025; 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.