Corcoran, Benjamin M
Corcoran, Benjamin M is an individual health care provider with primary practice located at 115 Wellness Dr , Williston VT 05495-2088. He recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, which is considered as his primary health care specialty. Corcoran, Benjamin M can be contacted via phone (802) 860-1358.Contact Information
Primary practice address
115 Wellness Dr
Williston VT 05495-2088
Phone: (802) 860-1358
Fax: (802) 860-1093
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist | 225100000X | 023544 | New York |
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist | 225100000X | 040-0003806 | Vermont |
Profile Details
| NPI number | 1083609531 |
|---|---|
| LBN Legal business name | Corcoran, Benjamin M |
| Credentials | M.S.,P.T. |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 12th, 2005 |
| Last updated | Dec 6th, 2012 - about 12 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1083609531 | NPPES |
| New York | MEDICAID | 02278839 | |
| New York | MEDICAID | 1018180 |
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