Provider Demographics
NPI:1518264746
Name:PASKI, SHIRLEY CATHERINE (MD)
Entity Type:Individual
Prefix:
First Name:SHIRLEY
Middle Name:CATHERINE
Last Name:PASKI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2049 E 100TH ST # A51
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44106-2104
Mailing Address - Country:US
Mailing Address - Phone:216-210-4344
Mailing Address - Fax:216-445-1378
Practice Address - Street 1:2049 E 100TH ST # A51
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44106-2104
Practice Address - Country:US
Practice Address - Phone:216-210-4344
Practice Address - Fax:216-445-1378
Is Sole Proprietor?:No
Enumeration Date:2011-02-24
Last Update Date:2022-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD60287526207RG0100X
IL036-120653207RG0100X
CAC151207207RG0100X
OH35.145922207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
0296568OtherL&I
WA1518264746Medicaid
WA1518264746Medicaid