Provider Demographics
NPI:1528082005
Name:HOHORST, ROBIN LYNN (DC)
Entity type:Individual
Prefix:
First Name:ROBIN
Middle Name:LYNN
Last Name:HOHORST
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:60 FERNDALE DRIVE
Mailing Address - Street 2:
Mailing Address - City:EASTON
Mailing Address - State:CT
Mailing Address - Zip Code:06612
Mailing Address - Country:US
Mailing Address - Phone:203-373-0003
Mailing Address - Fax:203-373-0018
Practice Address - Street 1:60 FERNDALE RD
Practice Address - Street 2:
Practice Address - City:EASTON
Practice Address - State:CT
Practice Address - Zip Code:06612-1936
Practice Address - Country:US
Practice Address - Phone:203-373-0003
Practice Address - Fax:203-373-0018
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-27
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000572111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT648904OtherACN
CT050000572CT01OtherBC/BS
CT002125OtherHEALTH NET
CT1386444003OtherCIGNA
CT4086676Medicaid
CT350000428Medicare ID - Type UnspecifiedMEDICARE