Provider Demographics
NPI:1881755312
Name:HARKULICH, JOHN F (PHD CLINICAL PSYCHOL)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:F
Last Name:HARKULICH
Suffix:
Gender:M
Credentials:PHD CLINICAL PSYCHOL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:419 SHUART AVE
Mailing Address - Street 2:
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13203-3025
Mailing Address - Country:US
Mailing Address - Phone:315-476-0957
Mailing Address - Fax:315-703-2730
Practice Address - Street 1:419 SHUART AVE
Practice Address - Street 2:
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13203-3025
Practice Address - Country:US
Practice Address - Phone:315-476-0957
Practice Address - Fax:315-703-2730
Is Sole Proprietor?:No
Enumeration Date:2006-12-12
Last Update Date:2020-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006637103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical