Provider Demographics
NPI:1174716856
Name:TOBIN, DAWN K (DC)
Entity type:Individual
Prefix:DR
First Name:DAWN
Middle Name:K
Last Name:TOBIN
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 1:28 WASHINGTON AVE
Mailing Address - Street 2:1ST FLOOR
Mailing Address - City:NORTH HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06473-2309
Mailing Address - Country:US
Mailing Address - Phone:203-314-1822
Mailing Address - Fax:
Practice Address - Street 1:28 WASHINGTON AVE
Practice Address - Street 2:1ST FLOOR
Practice Address - City:NORTH HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06473-2309
Practice Address - Country:US
Practice Address - Phone:203-314-1822
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-25
Last Update Date:2007-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT1484111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
11770585OtherCAQH PROVIDER ID