Provider Demographics
NPI:1972079234
Name:VALLON, BENJAMIN (DC)
Entity type:Individual
Prefix:DR
First Name:BENJAMIN
Middle Name:
Last Name:VALLON
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 ROBIN HOOD RD
Mailing Address - Street 2:
Mailing Address - City:SUFFERN
Mailing Address - State:NY
Mailing Address - Zip Code:10901-3809
Mailing Address - Country:US
Mailing Address - Phone:845-596-6320
Mailing Address - Fax:
Practice Address - Street 1:1574 ROUTE 9
Practice Address - Street 2:
Practice Address - City:WAPPINGERS FALLS
Practice Address - State:NY
Practice Address - Zip Code:12590-2846
Practice Address - Country:US
Practice Address - Phone:845-596-6320
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-15
Last Update Date:2018-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY013118111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor