| Doctor Name: | JAVIER MILTON MATOS |
| NPI Number: | 1275559965 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | LCSW |
| License Number: | 069411 |
| Business Practice Address: | 6014 60th St Suite B Maspeth, NY - 113783410 |
| Business Phone Number: | 7183666252 |
| Business Fax Number: | 7183666253 |
| Mailing Address: | 6014 60th St, Suite B MASPETH |
| State: | NY |
| Postal Code: | 113783410 |
| Phone Number: | 7183868527 |
| Fax Number: | 7188214499 |
| NPI Enumeration Date: | 07/14/2006 |
| NPI Last Update Date: | 09/20/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | 069411 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |