MEDICARE: DR. BENJAMIN VALLON DC

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	111N00000X	Chiropractor	013118	NY

General Provider Information

NPI Number	:	1972079234
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BENJAMIN VALLON DC

Provider Business Mailing Address
First Line	:	8 ROBIN HOOD RD
Second Line	:
City	:	SUFFERN
State	:	NY
Zip	:	10901-3809
Country	:	US
Telephone Number	:	845-596-6320
Fax Number	:

Provider Business Practice Location Address
First Line	:	1574 ROUTE 9
Second Line	:
City	:	WAPPINGERS FALLS
State	:	NY
Zip	:	12590-2846
Country	:	US
Telephone Number	:	845-596-6320
Fax Number	:

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

Provider Enumeration Date	:	10/15/2018
Last Update Date	:	10/15/2018

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