Provider Demographics
NPI:1053534800
Name:WEXLER, JOSEF R (PHD)
Entity type:Individual
Prefix:DR
First Name:JOSEF
Middle Name:R
Last Name:WEXLER
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 1:241 WALNUT ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLINE
Mailing Address - State:MA
Mailing Address - Zip Code:02445-6728
Mailing Address - Country:US
Mailing Address - Phone:617-731-9981
Mailing Address - Fax:
Practice Address - Street 1:196 BOSTON AVE
Practice Address - Street 2:SUITE 2500
Practice Address - City:MEDFORD
Practice Address - State:MA
Practice Address - Zip Code:02155-4236
Practice Address - Country:US
Practice Address - Phone:617-731-9981
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2492103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAWO2783OtherBCBSMA PROVIDER NUMBER