Provider Demographics
NPI:1225399819
Name:AFFORO, CLEMENT (RN)
Entity Type:Individual
Prefix:
First Name:CLEMENT
Middle Name:
Last Name:AFFORO
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7376 HICKORY LOG CIR
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21045-5001
Mailing Address - Country:US
Mailing Address - Phone:443-498-8335
Mailing Address - Fax:
Practice Address - Street 1:6040 SOUTHPORT DR
Practice Address - Street 2:
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20814-1848
Practice Address - Country:US
Practice Address - Phone:301-493-4200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-05-31
Last Update Date:2012-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR173139163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse