Provider Demographics
NPI:1659762060
Name:SAITO, TAKUYA
Entity Type:Individual
Prefix:DR
First Name:TAKUYA
Middle Name:
Last Name:SAITO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3-1-8 HAMADAYAMA
Mailing Address - Street 2:
Mailing Address - City:SUGINAMI
Mailing Address - State:TOKYO
Mailing Address - Zip Code:1680065
Mailing Address - Country:JP
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3-1-8 HAMADAYAMA
Practice Address - Street 2:
Practice Address - City:SUGINAMI
Practice Address - State:TOKYO
Practice Address - Zip Code:1680065
Practice Address - Country:JP
Practice Address - Phone:0906-007-9612
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-07
Last Update Date:2015-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2045742084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry