Provider Demographics
NPI:1699585828
Name:PRENETA, PETER PAUL
Entity type:Individual
Prefix:
First Name:PETER
Middle Name:PAUL
Last Name:PRENETA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18031 BIRCH HILL DR
Mailing Address - Street 2:
Mailing Address - City:CHAGRIN FALLS
Mailing Address - State:OH
Mailing Address - Zip Code:44023-5825
Mailing Address - Country:US
Mailing Address - Phone:440-364-9204
Mailing Address - Fax:
Practice Address - Street 1:18031 BIRCH HILL DR
Practice Address - Street 2:
Practice Address - City:CHAGRIN FALLS
Practice Address - State:OH
Practice Address - Zip Code:44023-5825
Practice Address - Country:US
Practice Address - Phone:440-364-9204
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-09
Last Update Date:2025-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty