Provider Demographics
NPI:1588719850
Name:JALBERT, RICHARD RAOUL JR (CRNFA)
Entity type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:RAOUL
Last Name:JALBERT
Suffix:JR
Gender:M
Credentials:CRNFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:351 NEW LONDON AVE APT 408
Mailing Address - Street 2:
Mailing Address - City:WARWICK
Mailing Address - State:RI
Mailing Address - Zip Code:02886-0668
Mailing Address - Country:US
Mailing Address - Phone:401-826-2731
Mailing Address - Fax:
Practice Address - Street 1:120 CENTERVILLE RD
Practice Address - Street 2:
Practice Address - City:WARWICK
Practice Address - State:RI
Practice Address - Zip Code:02886-4336
Practice Address - Country:US
Practice Address - Phone:401-738-3730
Practice Address - Fax:401-738-3777
Is Sole Proprietor?:No
Enumeration Date:2007-01-24
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIRN20363163WR0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First Assistant