Individual
MR. BERTHAIN SAMUEL DELILLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPA-C
Contact information
Practice address
150 55TH ST, BROOKLYN, NY 11220-2508
(718) 630-8718
Mailing address
150 55TH ST, BROOKLYN, NY 11220-2508
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
015579-1
NY
Other
Enumeration date
07/02/2012
Last updated
07/02/2012
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