Provider Demographics
NPI:1508158668
Name:CAFFREY, ELIZABETH A (RD)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:A
Last Name:CAFFREY
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1559 SULLIVAN AVE FL 2
Mailing Address - Street 2:
Mailing Address - City:SOUTH WINDSOR
Mailing Address - State:CT
Mailing Address - Zip Code:06074-2766
Mailing Address - Country:US
Mailing Address - Phone:860-696-2240
Mailing Address - Fax:
Practice Address - Street 1:1559 SULLIVAN AVE FL 2
Practice Address - Street 2:
Practice Address - City:SOUTH WINDSOR
Practice Address - State:CT
Practice Address - Zip Code:06074-2766
Practice Address - Country:US
Practice Address - Phone:860-696-2240
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-05-09
Last Update Date:2022-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000178133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered