Provider Demographics
NPI:1285727313
Name:ROBALLEY, THOMAS CHARLES (DC)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:CHARLES
Last Name:ROBALLEY
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 1:6515 MAIN ST STE 8
Mailing Address - Street 2:
Mailing Address - City:TRUMBULL
Mailing Address - State:CT
Mailing Address - Zip Code:06611-1388
Mailing Address - Country:US
Mailing Address - Phone:203-268-0035
Mailing Address - Fax:203-268-0046
Practice Address - Street 1:6515 MAIN ST STE 8
Practice Address - Street 2:
Practice Address - City:TRUMBULL
Practice Address - State:CT
Practice Address - Zip Code:06611-1388
Practice Address - Country:US
Practice Address - Phone:203-268-0035
Practice Address - Fax:203-268-0046
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-02
Last Update Date:2025-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT894111NX0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NX0800XChiropractic ProvidersChiropractorOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT0041-30902Medicaid
CT05-0000-894-CT03OtherBLUE CROSS PROVIDER I.D.
CT0041-30902Medicaid
CTUZ7529Medicare UPIN