Provider Demographics
NPI:1225135882
Name:MATSUI, WESLEY TAK (PHD)
Entity Type:Individual
Prefix:DR
First Name:WESLEY
Middle Name:TAK
Last Name:MATSUI
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:483 STANDISH RD
Mailing Address - Street 2:
Mailing Address - City:TEANECK
Mailing Address - State:NJ
Mailing Address - Zip Code:07666-2605
Mailing Address - Country:US
Mailing Address - Phone:201-836-2108
Mailing Address - Fax:
Practice Address - Street 1:135 COLUMBIA TPKE
Practice Address - Street 2:SUITE 303
Practice Address - City:FLORHAM PARK
Practice Address - State:NJ
Practice Address - Zip Code:07932-2104
Practice Address - Country:US
Practice Address - Phone:973-377-3116
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ2416103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling