Provider Demographics
NPI:1629827290
Name:AFFUL, FELICITY EMELIA
Entity type:Individual
Prefix:
First Name:FELICITY
Middle Name:EMELIA
Last Name:AFFUL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 CATAN DRIVE
Mailing Address - Street 2:
Mailing Address - City:CHESTER
Mailing Address - State:NJ
Mailing Address - Zip Code:07930
Mailing Address - Country:US
Mailing Address - Phone:929-532-8912
Mailing Address - Fax:973-584-4701
Practice Address - Street 1:1 CATAN DRIVE
Practice Address - Street 2:
Practice Address - City:CHESTER
Practice Address - State:NJ
Practice Address - Zip Code:07930
Practice Address - Country:US
Practice Address - Phone:973-866-6777
Practice Address - Fax:973-584-4701
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-16
Last Update Date:2024-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJOH51096667251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health