Provider Demographics
NPI:1043852254
Name:AFFRUNTI, STEPHANIE (MA, CCC-SLP, TSSLD)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:
Last Name:AFFRUNTI
Suffix:
Gender:F
Credentials:MA, CCC-SLP, TSSLD
Other - Prefix:
Other - First Name:STEPHANIE
Other - Middle Name:
Other - Last Name:BONANNO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA, CCC-SLP, TSSLD
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:347-233-0492
Mailing Address - Fax:
Practice Address - Street 1:65 COURT STREET
Practice Address - Street 2:RM. 102
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11201-4918
Practice Address - Country:US
Practice Address - Phone:718-935-4000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-09
Last Update Date:2024-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist