Provider Demographics
NPI:1710023700
Name:VOLK, GRETCHEN R (MD)
Entity Type:Individual
Prefix:DR
First Name:GRETCHEN
Middle Name:R
Last Name:VOLK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:497 BEAHAN RD
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14624-3403
Mailing Address - Country:US
Mailing Address - Phone:585-247-5400
Mailing Address - Fax:585-319-4124
Practice Address - Street 1:497 BEAHAN RD
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14624-3403
Practice Address - Country:US
Practice Address - Phone:585-247-5400
Practice Address - Fax:585-319-4124
Is Sole Proprietor?:No
Enumeration Date:2007-01-29
Last Update Date:2017-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY208254208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY010208254OtherBLUE CHOICE
NY02135459Medicaid
NY110326DLOtherPREFERRED CARE
NY7209210OtherAETNA
NY000918105002OtherHEALTH NOW
NY010208254OtherBLUE CROSS & BLUE SHIELD