Healthcare Provider Details

I. General information

NPI: 1518725597
Provider Name (Legal Business Name): JONATHAN D CONSIDINE
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/13/2024
Last Update Date: 08/14/2026
Certification Date: 08/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

628 PARK AVE
CRANSTON RI
02910-2165
US

IV. Provider business mailing address

628 PARK AVE
CRANSTON RI
02910-2165
US

V. Phone/Fax

Practice location:
  • Phone: 401-200-8031
  • Fax: 401-383-5933
Mailing address:
  • Phone: 401-200-8031
  • Fax: 401-383-5933

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: