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General NPI Number Information
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NPI Number | 1114703071
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Entity Type | Individual
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Provider Name | BENJAMIN MARX
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Gender | Male
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Dates
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Enumeration Date | 09/06/2023
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Last Update Date | 09/06/2023
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Provider Practice Location Address
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Address Line | 85 GRAND ST
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City | KINGSTON
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State | NY
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Zip | 12401-3907
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Country | US
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Telephone | 347-661-3000
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Fax |
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Provider Business Mailing Address
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Address Line | 14 POND PARK RD
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City | WOODSTOCK
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State | NY
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Zip | 12498-1703
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Country | US
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Telephone | 347-661-3000
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225A00000X
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Taxonomy Name | Music Therapist
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License Number | 17655
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License Number State | NY
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