Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QS0010X | Family Doctor - Sports Medicine | 290955 | NY |
NPI | 1013365014 |
---|---|
Provider Name | Benjamin Max Kammerman |
First Address | Binghamton, NY 13905-1048 |
Second Address | Vestal, NY 13850-3556 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/05/2016 |
Last Update Date | 23/09/2020 |