Provider Demographics
NPI:1891882296
Name:CONFALONE, ELIZABETH MARIE (DPM)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:MARIE
Last Name:CONFALONE
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26908 DETROIT RD
Mailing Address - Street 2:#301
Mailing Address - City:WESTLAKE
Mailing Address - State:OH
Mailing Address - Zip Code:44145-2398
Mailing Address - Country:US
Mailing Address - Phone:440-617-1823
Mailing Address - Fax:440-617-0884
Practice Address - Street 1:26908 DETROIT RD
Practice Address - Street 2:#200
Practice Address - City:WESTLAKE
Practice Address - State:OH
Practice Address - Zip Code:44145-2398
Practice Address - Country:US
Practice Address - Phone:440-250-8660
Practice Address - Fax:440-250-8639
Is Sole Proprietor?:No
Enumeration Date:2006-10-06
Last Update Date:2020-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH36003007213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2037012Medicaid
OH2037012Medicaid
OH0829775Medicare PIN
OH0829775Medicare PIN