Healthcare Provider Details

I. General information

NPI: 1104080076
Provider Name (Legal Business Name): OXANA MATSENKO MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DR. OKSANA MATSENKO KHENKIN

II. Dates (important events)

Enumeration Date: 07/10/2008
Last Update Date: 06/17/2026
Certification Date: 06/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

560 SYLVAN AVE STE 2115
ENGLEWOOD CLIFFS NJ
07632-3166
US

IV. Provider business mailing address

26-14 FAIR LAWN AVE
FAIR LAWN NJ
07410-4382
US

V. Phone/Fax

Practice location:
  • Phone: 201-731-8899
  • Fax: 201-685-0012
Mailing address:
  • Phone: 201-731-8899
  • Fax: 201-685-0012

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number25 MA08273900
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: