Individual
DOREEN T PESKIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
9500 EUCLID AVE, CLEVELAND, OH 44195-0001
(180) 022-3227
Mailing address
6000 W CREEK RD, SUITE 10, INDEPENDENCE, OH 44131-2139
(216) 986-1314
(216) 986-1191
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN150472
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000221305
UNISON
OH
01
—
000000516004
ANTHEM
OH
01
—
0583328
BCMH
OH
05
—
0814015
—
OH
01
—
415021
WELLCARE MEDICAID
OH
01
—
750948
BUCKEYE MEDICAID
OH
01
—
7802551
AETNA
OH
Enumeration date
04/18/2006
Last updated
05/19/2008
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