Healthcare Provider Details

I. General information

NPI: 1063637114
Provider Name (Legal Business Name): ELIZABETH M CONFALONE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/16/2007
Last Update Date: 01/23/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

29101 HEALTH CAMPUS DR SUITE 200
WESTLAKE OH
44145-5270
US

IV. Provider business mailing address

4758 RIDGE RD #161
CLEVELAND OH
44144-3327
US

V. Phone/Fax

Practice location:
  • Phone: 440-892-6555
  • Fax: 440-835-1996
Mailing address:
  • Phone: 440-236-8484
  • Fax: 440-236-8470

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0131X
TaxonomyFoot Surgery Podiatrist
License Number36003007-C
License Number StateOH

VIII. Authorized Official

Name: ELIZABETH M CONFALONE
Title or Position: OWNER
Credential: DPM
Phone: 440-892-6555