Provider Demographics
NPI:1730791377
Name:CONFALONE, DONALD RICHARD JR
Entity type:Individual
Prefix:MR
First Name:DONALD
Middle Name:RICHARD
Last Name:CONFALONE
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 MOORE ST
Mailing Address - Street 2:
Mailing Address - City:RUMFORD
Mailing Address - State:RI
Mailing Address - Zip Code:02916-2015
Mailing Address - Country:US
Mailing Address - Phone:401-580-5717
Mailing Address - Fax:
Practice Address - Street 1:525 TAUNTON AVE
Practice Address - Street 2:
Practice Address - City:EAST PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02914-1604
Practice Address - Country:US
Practice Address - Phone:140-143-8317
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-17
Last Update Date:2020-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
1295818078OtherEAST PROVIDENCE URGENT CARE