MEDICARE: MR. BENJAMIN H PALMER IV M.A. CCC-SLP

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	235Z00000X	Speech-Language Pathologist	017094	NY

General Provider Information

NPI Number	:	1679729123
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. BENJAMIN H PALMER IV M.A. CCC-SLP

Provider Business Mailing Address
First Line	:	6890 TWIN VALLEY TER
Second Line	:
City	:	ALMOND
State	:	NY
Zip	:	14804-9705
Country	:	US
Telephone Number	:	607-276-2593
Fax Number	:

Provider Business Practice Location Address
First Line	:	6795 STATE ROUTE 21
Second Line	:
City	:	ALMOND
State	:	NY
Zip	:	14804-9716
Country	:	US
Telephone Number	:	607-276-6525
Fax Number	:

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

Provider Enumeration Date	:	08/15/2008
Last Update Date	:	07/15/2019

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Directions to “ MR. BENJAMIN H PALMER IV M.A. CCC-SLP” Practice Location

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