Provider Demographics
NPI:1114181757
Name:ZYLKO, KATHLEEN J (RN)
Entity Type:Individual
Prefix:MRS
First Name:KATHLEEN
Middle Name:J
Last Name:ZYLKO
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4504 ST RTE 55
Mailing Address - Street 2:DAYTOP VILLAGE INC
Mailing Address - City:SWAN LAKE
Mailing Address - State:NY
Mailing Address - Zip Code:12783
Mailing Address - Country:US
Mailing Address - Phone:845-292-6875
Mailing Address - Fax:845-292-4873
Practice Address - Street 1:4504 ST RTE 55
Practice Address - Street 2:DAYTOP VILLAGE INC
Practice Address - City:SWAN LAKE
Practice Address - State:NY
Practice Address - Zip Code:12783
Practice Address - Country:US
Practice Address - Phone:845-292-6875
Practice Address - Fax:845-292-4873
Is Sole Proprietor?:No
Enumeration Date:2008-07-14
Last Update Date:2008-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2439541163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse