MEDICARE: ELAINE LOURDES AFANADOR-PEREIRA LMSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	097931	NY
2	104100000X	Social Worker	111404	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	097931	OTHER	NY	NYS EDUCATION DEPARTMENT OFFICE OF THE PROFESSIONS
2	111404	OTHER	NY	NYS EDUCATION DEPARTMENT OFFICE OF THE PROFESSIONS

General Provider Information

NPI Number	:	1043970353
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELAINE LOURDES AFANADOR-PEREIRA LMSW

Provider Business Mailing Address
First Line	:	3306 WOODWARD ST
Second Line	:
City	:	OCEANSIDE
State	:	NY
Zip	:	11572-4527
Country	:	US
Telephone Number	:	917-497-4233
Fax Number	:

Provider Business Practice Location Address
First Line	:	3306 WOODWARD ST
Second Line	:
City	:	OCEANSIDE
State	:	NY
Zip	:	11572-4527
Country	:	US
Telephone Number	:	917-497-4233
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/28/2021
Last Update Date	:	05/07/2026

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