Jeanette Martucci, PSY.D

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

5151 Issued in NJ

Practice address

468 Columbia Ave
Cliffside Park, NJ 07010-1909

Phone

(201) 954-0367

NPI assigned

Mar 8, 2015

Last updated

Mar 8, 2015By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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

• Senior Care Therapy LLC

  • Clinical Psychologist
  • Passaic, NJ
  • NPI 1285898098
  Medicare reassignment NPD

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

{
    "created_epoch": "1425772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1425772800000",
    "number": "1316330822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "742 BERGEN BLVD",
            "city": "RIDGEFIELD",
            "state": "NJ",
            "postal_code": "076571435",
            "telephone_number": "201-954-0367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "468 COLUMBIA AVE",
            "city": "CLIFFSIDE PARK",
            "state": "NJ",
            "postal_code": "070101909",
            "telephone_number": "201-954-0367"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTUCCI",
        "first_name": "JEANETTE",
        "name_prefix": "Dr.",
        "credential": "PSY.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-03-08",
        "last_updated": "2015-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NJ",
            "license": "5151",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Helene D Manno, DPM
• Bernadette Marcelo
• Eric Margolis
• Rafael Aaron Marinelli, PT, DPT, L.A.C.
• Jesse Markowitz, PA
• Erisa Maska, APN
• Violet S Master, M.D.
• Angelica Matteo, MD
• Mayfair Surgery Center
• Morombaye Kabra Mbaidjol, M.D.

• Clinical Psychologist in Cliffside Park, NJ
• Providers in Cliffside Park, NJ by specialty
• Clinical Psychologist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.