Provider Demographics
NPI:1255546339
Name:SHRECK, ROVENA HONEY (MA)
Entity type:Individual
Prefix:MRS
First Name:ROVENA
Middle Name:HONEY
Last Name:SHRECK
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:92 KAROL PL
Mailing Address - Street 2:
Mailing Address - City:JERICHO
Mailing Address - State:NY
Mailing Address - Zip Code:11753-1321
Mailing Address - Country:US
Mailing Address - Phone:516-681-1912
Mailing Address - Fax:516-681-4048
Practice Address - Street 1:92 KAROL PL
Practice Address - Street 2:
Practice Address - City:JERICHO
Practice Address - State:NY
Practice Address - Zip Code:11753-1321
Practice Address - Country:US
Practice Address - Phone:516-681-1912
Practice Address - Fax:516-681-4048
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY190235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist