Provider Demographics
NPI:1366989295
Name:PLISKA, SEAN
Entity type:Individual
Prefix:
First Name:SEAN
Middle Name:
Last Name:PLISKA
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 1:1719 STANHOPE ST
Mailing Address - Street 2:#3L
Mailing Address - City:RIDGEWOOD
Mailing Address - State:NY
Mailing Address - Zip Code:11385-1440
Mailing Address - Country:US
Mailing Address - Phone:503-704-6798
Mailing Address - Fax:
Practice Address - Street 1:1719 STANHOPE ST
Practice Address - Street 2:#3L
Practice Address - City:RIDGEWOOD
Practice Address - State:NY
Practice Address - Zip Code:11385-1440
Practice Address - Country:US
Practice Address - Phone:503-704-6798
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-30
Last Update Date:2017-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist