Individual ProviderIvan DillerSocial WorkerBehavioral Health & Social Service ProvidersPractice Address180 S Broadway Ste 409, White Plains, NY 10605(917) 805-0044PECOS EnrollmentBased on the most recent information from CMS, provider Ivan Diller is legally eligible to order and refer claims for Part B and DME services only.Part BMedicare Part BEnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1316145816Provider TypeIndividualFull NameDiller, IvanGenderMaleSole ProprietorNoEnumeration Date7/5/2007Last Updated8/10/2018Contact InformationPractice LocationPractice Address180 S Broadway Ste 409, White Plains, NY 10605Phone(917) 805-0044Fax(718) 684-4896Mailing LocationMailing Address180 S Broadway Ste 409, White Plains, NY 10605-1820Phone(917) 805-0044Fax(718) 684-4896Provider TaxonomiesCodeDescriptionLicenseCode1041C0700XPrimaryDescriptionSocial WorkerBehavioral Health & Social Service ProvidersLicenseUnlisted Issuer