Provider Demographics
NPI:1689733545
Name:DRS ROBBIN CAPPADONA & ASSOCIATES
Entity Type:Organization
Organization Name:DRS ROBBIN CAPPADONA & ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:ROBBIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:860-651-4907
Mailing Address - Street 1:720 HOPMEADOW ST
Mailing Address - Street 2:
Mailing Address - City:SIMSBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06070-2224
Mailing Address - Country:US
Mailing Address - Phone:860-651-4907
Mailing Address - Fax:860-529-1363
Practice Address - Street 1:720 HOPMEADOW ST
Practice Address - Street 2:
Practice Address - City:SIMSBURY
Practice Address - State:CT
Practice Address - Zip Code:06070-2224
Practice Address - Country:US
Practice Address - Phone:860-651-4907
Practice Address - Fax:860-529-1363
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT207RA0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RA0000XAllopathic & Osteopathic PhysiciansInternal MedicineAdolescent MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT4209898Medicaid
CTC02690Medicare ID - Type UnspecifiedGROUP PROVIDER NUMBER