Individual provider Active NPI

Andinase Gianna Rubertone, MS, BCBA

  • Behavior Analyst
  • Cherry Hill, NJ
National Provider Identifier
1750984100
Registry record updated Jul 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
12041524 Issued in NJ
Practice address
1851 Old Cuthbert Rd
Cherry Hill, NJ 08034-1415
Phone
(484) 681-2170
NPI assigned
Nov 18, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X 12041524 NJ Primary

Addresses

Primary practice location

1851 Old Cuthbert Rd
Cherry Hill, NJ 08034-1415

Mailing address

58 E Meadowbrook Cir
Sicklerville, NJ 08081-1668
Phone (609) 670-0212

Other practice location 1

500 S Burnt Mill Rd
Voorhees, NJ 08043-2205
Phone (888) 859-7749

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
12041524NJMDBehavioral Analyst

NPI Registry JSON

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

{
    "created_epoch": "1605657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625097600000",
    "number": "1750984100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "58 E MEADOWBROOK CIR",
            "city": "SICKLERVILLE",
            "state": "NJ",
            "postal_code": "080811668",
            "telephone_number": "609-670-0212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1851 OLD CUTHBERT RD",
            "city": "CHERRY HILL",
            "state": "NJ",
            "postal_code": "080341415",
            "telephone_number": "484-681-2170"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "500 S Burnt Mill Rd",
            "address_purpose": "LOCATION",
            "city": "Voorhees",
            "state": "NJ",
            "postal_code": "080432205",
            "country_code": "US",
            "telephone_number": "888-859-7749",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RUBERTONE",
        "first_name": "ANDINASE",
        "middle_name": "GIANNA",
        "credential": "MS, BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-11-18",
        "last_updated": "2021-07-01",
        "certification_date": "2021-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "NJ",
            "license": "12041524",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cherry Hill, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2021; 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.