Healthcare Provider Details

I. General information

NPI: 1285727313
Provider Name (Legal Business Name): THOMAS CHARLES ROBALLEY D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/02/2006
Last Update Date: 04/22/2025
Certification Date: 04/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6515 MAIN ST STE 8
TRUMBULL CT
06611-1388
US

IV. Provider business mailing address

6515 MAIN ST STE 8
TRUMBULL CT
06611-1388
US

V. Phone/Fax

Practice location:
  • Phone: 203-268-0035
  • Fax: 203-268-0046
Mailing address:
  • Phone: 203-268-0035
  • Fax: 203-268-0046

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NX0800X
TaxonomyOrthopedic Chiropractor
License Number894
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: