Provider Demographics
NPI:1215019435
Name:COLSEN, SEAN ANDREW (DPM)
Entity type:Individual
Prefix:DR
First Name:SEAN
Middle Name:ANDREW
Last Name:COLSEN
Suffix:
Gender:M
Credentials:DPM
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Mailing Address - Street 1:40 RAILROAD AVE
Mailing Address - Street 2:
Mailing Address - City:PLAINFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06374-1217
Mailing Address - Country:US
Mailing Address - Phone:860-564-8671
Mailing Address - Fax:860-564-8672
Practice Address - Street 1:16 LINCOLN AVE
Practice Address - Street 2:
Practice Address - City:PAWCATUCK
Practice Address - State:CT
Practice Address - Zip Code:06379-1856
Practice Address - Country:US
Practice Address - Phone:860-564-8671
Practice Address - Fax:860-564-8672
Is Sole Proprietor?:No
Enumeration Date:2006-10-19
Last Update Date:2019-10-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CT000733213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
U80922Medicare UPIN