Provider Demographics
NPI:1104938950
Name:ROBOTHAM, SEAN F (DC)
Entity type:Individual
Prefix:MR
First Name:SEAN
Middle Name:F
Last Name:ROBOTHAM
Suffix:
Gender:
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:107 OLD WINDSOR RD
Mailing Address - Street 2:
Mailing Address - City:BLOOMFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06002-1400
Mailing Address - Country:US
Mailing Address - Phone:860-206-8198
Mailing Address - Fax:860-242-0274
Practice Address - Street 1:107 OLD WINDSOR RD
Practice Address - Street 2:
Practice Address - City:BLOOMFIELD
Practice Address - State:CT
Practice Address - Zip Code:06002-1400
Practice Address - Country:US
Practice Address - Phone:860-206-8198
Practice Address - Fax:860-242-0274
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2025-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001213111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT050001213CT01OtherBCBS
U84097Medicare UPIN