Provider Demographics
NPI:1477523462
Name:BITSKAY, JEANINE A (DC)
Entity Type:Individual
Prefix:MRS
First Name:JEANINE
Middle Name:A
Last Name:BITSKAY
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:103 KIMBERLY DR
Mailing Address - Street 2:
Mailing Address - City:CRESTON
Mailing Address - State:OH
Mailing Address - Zip Code:44217-9425
Mailing Address - Country:US
Mailing Address - Phone:330-620-1159
Mailing Address - Fax:
Practice Address - Street 1:708 E SMITH RD
Practice Address - Street 2:
Practice Address - City:MEDINA
Practice Address - State:OH
Practice Address - Zip Code:44256-2662
Practice Address - Country:US
Practice Address - Phone:330-725-5277
Practice Address - Fax:330-725-4241
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-24
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1734111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000139761OtherANTHEM
OH0857210Medicaid
OH20813900OtherUS DEPT. OF LABOR-GROUP#
OH341774514-00OtherWORKER'S COMP
OH0221638Medicaid
OH34182024800OtherGROUP WORKERS COMP #
OH1734OtherLICENSE
OHBA9283421Medicare ID - Type UnspecifiedGROUP MEDICARE #
OH000000139761OtherANTHEM
OHBIO701665Medicare PIN