Gina Marie Restivo, PSYD, BCBA-D, NCSP

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

1-05-2413 Issued in NJ

Practice address

20 Pelham PL
Bergenfield, NJ 07621-1613

Phone

(551) 486-9848

NPI assigned

Aug 5, 2011

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1312502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1312502400000",
    "number": "1568741676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 PELHAM PL",
            "city": "BERGENFIELD",
            "state": "NJ",
            "postal_code": "076211613",
            "telephone_number": "551-486-9848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 PELHAM PL",
            "city": "BERGENFIELD",
            "state": "NJ",
            "postal_code": "076211613",
            "telephone_number": "551-486-9848"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RESTIVO",
        "first_name": "GINA",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "PSYD, BCBA-D, NCSP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-08-05",
        "last_updated": "2011-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "NJ",
            "license": "1-05-2413",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Behavior Analyst in Bergenfield, NJ
• Providers in Bergenfield, NJ by specialty
• Behavior Analyst in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2011; 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.