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NPI Code Detail

MEDICARE: ERYKA PESKIN

MEDICARE:   ERYKA  PESKIN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1104100000XSocial WorkerLMSW-38950ID
2104100000XSocial Worker075073NY

General Provider Information

NPI Number : 1740143916
Entity Type Code : Individual
Provider Name (Legal Business Name) : ERYKA PESKIN
Provider Business Mailing Address
First Line : 2319 N 28TH ST
Second Line :
City : BOISE
State : ID
Zip : 83703-5609
Country : US
Telephone Number : 917-822-8953
Fax Number :
Provider Business Practice Location Address
First Line : 2319 N 28TH ST
Second Line :
City : BOISE
State : ID
Zip : 83703-5609
Country : US
Telephone Number : 917-822-8953
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/04/2025
Last Update Date : 12/04/2025

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Directions to “ ERYKA PESKIN ” Practice Location

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