MEDICARE: DR. BENNETT S. PALLANT MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician	104254	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	33D0138103	OTHER	NY	CLIA
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1174520316
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BENNETT S. PALLANT MD

Provider Business Mailing Address
First Line	:	6 KATHRYN LN
Second Line	:
City	:	MAHOPAC
State	:	NY
Zip	:	10541-4426
Country	:	US
Telephone Number	:	914-629-1124
Fax Number	:	888-876-4988

Provider Business Practice Location Address
First Line	:	6 KATHRYN LN
Second Line	:
City	:	MAHOPAC
State	:	NY
Zip	:	10541
Country	:	US
Telephone Number	:	914-629-1124
Fax Number	:	888-876-4988

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/01/2005
Last Update Date	:	08/18/2018

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