Healthcare Provider Details

I. General information

NPI: 1669302550
Provider Name (Legal Business Name): ELIZABETH PLOSKUNAK CAA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/21/2026
Last Update Date: 05/21/2026
Certification Date: 05/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11100 EUCLID AVE
CLEVELAND OH
44106-1716
US

IV. Provider business mailing address

565 LANTERN WAY
AURORA OH
44202-7715
US

V. Phone/Fax

Practice location:
  • Phone: 216-844-5583
  • Fax:
Mailing address:
  • Phone: 910-308-0894
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367H00000X
TaxonomyAnesthesiologist Assistant
License Number67.000611
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: