Provider Demographics
NPI:1962540971
Name:AFFRUNTI, ELIZABETH CATHERINA (DDS)
Entity type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:CATHERINA
Last Name:AFFRUNTI
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2125 JACKSON AVE
Mailing Address - Street 2:
Mailing Address - City:SEAFORD
Mailing Address - State:NY
Mailing Address - Zip Code:11783-2605
Mailing Address - Country:US
Mailing Address - Phone:516-781-4990
Mailing Address - Fax:516-826-5429
Practice Address - Street 1:2125 JACKSON AVE
Practice Address - Street 2:
Practice Address - City:SEAFORD
Practice Address - State:NY
Practice Address - Zip Code:11783-2605
Practice Address - Country:US
Practice Address - Phone:516-781-4990
Practice Address - Fax:516-826-5429
Is Sole Proprietor?:No
Enumeration Date:2007-02-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0423741223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice