Provider Demographics
NPI:1265610885
Name:VOLSKAYA, SVETLANA
Entity type:Individual
Prefix:DR
First Name:SVETLANA
Middle Name:
Last Name:VOLSKAYA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 SANATORIUM RD
Mailing Address - Street 2:C /O HAGEDORN PSYCHIATRIC HOSPITAL
Mailing Address - City:GLEN GARDNER
Mailing Address - State:NJ
Mailing Address - Zip Code:08826-3288
Mailing Address - Country:US
Mailing Address - Phone:908-537-2141
Mailing Address - Fax:908-537-3186
Practice Address - Street 1:200 SANATORIUM RD
Practice Address - Street 2:C/O HAGEDORN PSYCHIATRIC HOSPITAL
Practice Address - City:GLEN GARDNER
Practice Address - State:NJ
Practice Address - Zip Code:08826-3288
Practice Address - Country:US
Practice Address - Phone:908-537-2141
Practice Address - Fax:908-537-3186
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-06
Last Update Date:2012-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA066698002084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ028491C2FOtherMEDICARE BILLING NO.
NJ4508203Medicaid
G97097Medicare UPIN
NJV0028491Medicare PIN