Look up the most recent NPI and PECOS records

Berthain Samuel Delille

Physician Assistant

Physician Assistants & Advanced Practice Nursing Providers

PECOS Enrollment

This provider is enrolled in PECOS as BERTHAIN DELILLE.

Based on the most recent information from CMS, provider Berthain Samuel Delille is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records today at 9:43 AM.

Profile Details

Provider ID
1124382304
Provider Type
Individual
Full Name
Delille, Berthain Samuel
Title
Mr.
Credential
RPA-C

Gender
Male
Sole Proprietor
No
Enumeration Date
7/2/2012
Last Updated
7/2/2012

Contact Information

Practice Location

150 55th St, Brooklyn, NY 11220-2508

(718) 630-8718

Unlisted Fax

Mailing Location

150 55th St, Brooklyn, NY 11220-2508

Unlisted Phone

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 363A00000X Primary	Description Physician Assistant Physician Assistants & Advanced Practice Nursing Providers	License 015579-1 New York

Berthain Samuel Delille

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Hashimi, Patima

Ho, Teresa

Garbulsky, Michael

Weston, Jennifer M

Lin, Ting-Hsu

Shenk-Foley, Tyler

Kong, Wendy

Loesch, Jesse Patrick

Cohen, Osnat

Fratamico, Alexandria Rose