Elyssa Martino, MA

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

BACB765732 Issued in NJ

Practice address

96 Chadwick St
East Rutherford, NJ 07073-1603

Phone

(201) 414-1568

NPI assigned

Dec 11, 2024

Last updated

Dec 11, 2024By 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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

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

{
    "created_epoch": "1733875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733875200000",
    "number": "1578370706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "96 CHADWICK ST",
            "city": "EAST RUTHERFORD",
            "state": "NJ",
            "postal_code": "070731603",
            "telephone_number": "201-414-1568"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "96 CHADWICK ST",
            "city": "EAST RUTHERFORD",
            "state": "NJ",
            "postal_code": "070731603",
            "telephone_number": "201-414-1568"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTINO",
        "first_name": "ELYSSA",
        "credential": "MA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-12-11",
        "last_updated": "2024-12-11",
        "certification_date": "2024-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NJ",
            "license": "BACB765732",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rachel Long, L.C.S.W.
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• Justin Daniel Maher, ATC, PT, DPT
• Elisabeth Elaine Maichin, MSC
• Carolyn Maso, M.A. CCC-SLP
• Taylore Allie Mastbeth
• Maxwell Gear LLC
• Nephra McDonald
• Med-Care of East Rutherford, Inc.

• Community/Behavioral Health Agency in East Rutherford, NJ
• Providers in East Rutherford, NJ by specialty
• Community/Behavioral Health Agency in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2024; 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.