Provider Demographics
NPI:1104218742
Name:ESPOSITO, SHEILA (MA,CCC/SLP)
Entity Type:Individual
Prefix:
First Name:SHEILA
Middle Name:
Last Name:ESPOSITO
Suffix:
Gender:F
Credentials:MA,CCC/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 RAYMOND ST
Mailing Address - Street 2:
Mailing Address - City:HARRINGTON PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07640-1213
Mailing Address - Country:US
Mailing Address - Phone:201-803-3749
Mailing Address - Fax:
Practice Address - Street 1:55 WALNUT ST
Practice Address - Street 2:
Practice Address - City:NORWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07648-1335
Practice Address - Country:US
Practice Address - Phone:201-768-7272
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-18
Last Update Date:2015-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ41YS00209100235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist