Angelina Marie Longo, M.A, BCBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

12041120 Issued in NJ

Practice address

1 Stone Ave
Elmwood Park, NJ 07407-1150

Phone

(973) 572-4216

NPI assigned

Jun 14, 2022

Sex

Female

Sole proprietor

No

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

Practice roles

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.

• Shining Minds LLC

  • Behavior Analyst
  • Elmwood Park, NJ
  • NPI 1831843473
  NPD Authorized official

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

{
    "created_epoch": "1655164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655164800000",
    "number": "1609506591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "132 HOLLYWOOD AVE",
            "city": "FAIRFIELD",
            "state": "NJ",
            "postal_code": "070041223",
            "telephone_number": "973-647-2745"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 STONE AVE",
            "city": "ELMWOOD PARK",
            "state": "NJ",
            "postal_code": "074071150",
            "telephone_number": "973-572-4216"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LONGO",
        "first_name": "ANGELINA",
        "middle_name": "MARIE",
        "credential": "M.A, BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-14",
        "last_updated": "2022-06-14",
        "certification_date": "2022-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "NJ",
            "license": "12041120",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• PO-Shing Lee, M.D.
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• Boris Livshits, M.D.
• Lisa Lukas
• Michael K Maley, MD
• Heather E Manspeizer, MD
• Masters Ambulance Service
• Damiano Mazza

• Behavior Analyst in Elmwood Park, NJ
• Providers in Elmwood Park, 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 Jun 14, 2022; 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.