Provider Demographics
NPI:1861996886
Name:VOLCKO, JOHN DAVID (RN)
Entity type:Individual
Prefix:MR
First Name:JOHN
Middle Name:DAVID
Last Name:VOLCKO
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2808 HILTONWOOD RD
Mailing Address - Street 2:
Mailing Address - City:BALDWINSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:13027-9294
Mailing Address - Country:US
Mailing Address - Phone:315-635-4633
Mailing Address - Fax:
Practice Address - Street 1:HUTCHINGS PSYCHIATRIC CENTER
Practice Address - Street 2:620 MADISON STREET
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13210-9294
Practice Address - Country:US
Practice Address - Phone:315-426-3600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-23
Last Update Date:2024-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY490329163WA2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WA2000XNursing Service ProvidersRegistered NurseAdministratorGroup - Single Specialty