Provider Demographics
NPI:1558756056
Name:DRISKA, SHEILA ROSE (SLP)
Entity Type:Individual
Prefix:MRS
First Name:SHEILA
Middle Name:ROSE
Last Name:DRISKA
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:60 HIGH ST
Mailing Address - Street 2:
Mailing Address - City:SUMMIT
Mailing Address - State:NJ
Mailing Address - Zip Code:07901-1802
Mailing Address - Country:US
Mailing Address - Phone:908-273-0490
Mailing Address - Fax:
Practice Address - Street 1:60 HIGH ST
Practice Address - Street 2:
Practice Address - City:SUMMIT
Practice Address - State:NJ
Practice Address - Zip Code:07901-1802
Practice Address - Country:US
Practice Address - Phone:908-723-2559
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-01
Last Update Date:2015-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ41YS00804900235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist