Healthcare Provider Details

I. General information

NPI: 1891090411
Provider Name (Legal Business Name): CEIL M DROSKY LSP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/12/2011
Last Update Date: 01/12/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1068 HUDSON AVE
STILLWATER NY
12170-3432
US

IV. Provider business mailing address

21 VAN TASSELL LN
BALLSTON SPA NY
12020-3063
US

V. Phone/Fax

Practice location:
  • Phone: 518-373-6100
  • Fax:
Mailing address:
  • Phone: 518-584-3453
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number003518
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: