Svetlana Volskaya

Individual provider Active NPI Psychiatry Physician · Glen Gardner, NJ

NPI 1265610885 · NPPES record last updated Mar 5, 2012

Key facts

NPI
1265610885
Entity type
Individual (NPI type 1)
Primary specialty
Psychiatry Physician 2084P0800X
License
25MA06669800 (NJ)
Practice address
200 Sanatorium Rd
C/O Hagedorn Psychiatric Hospital
Glen Gardner, NJ 08826-3288
Phone
(908) 537-2141
Fax
(908) 537-3186
NPI assigned
Feb 6, 2008
Sex
Female
Sole proprietor
Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20120711000115 NJ Practitioner - Psychiatry 2961667274 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
25MA06669800NJMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
State of New Jersey Omb Centralized Payroll Current
since Mar 24, 2012
Accepting new patients

Locations

200 Sanatorium Rd
Glen Gardner, NJ 08826
Phone (908) 537-2141

200 Sanatorium Rd
#C
Glen Gardner, NJ 08826

59 Koch Ave
Morris Plains, NJ 07950
Phone (973) 889-4390

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 25MA06669800 NJ Yes

Addresses

Primary practice location

200 Sanatorium Rd
C/O Hagedorn Psychiatric Hospital
Glen Gardner, NJ 08826-3288

Mailing address

200 Sanatorium Rd
C /O Hagedorn Psychiatric Hospital
Glen Gardner, NJ 08826-3288
Phone (908) 537-2141

Other identifiers

IdentifierTypeStateIssuer
028491C2FOtherNJMEDICARE BILLING NO.
4508203MedicaidNJ

Other providers in Glen Gardner, NJ

All providers in Glen Gardner, NJ · Psychiatry Physician in New Jersey

Sources for this page

Verify at the official NPI Registry.