Provider Demographics
NPI:1144270703
Name:KITTELBERGER, JAMES (PT)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:
Last Name:KITTELBERGER
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1699 WASHINGTON RD
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15228-1629
Mailing Address - Country:US
Mailing Address - Phone:412-831-5155
Mailing Address - Fax:412-831-8060
Practice Address - Street 1:1699 WASHINGTON RD
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15228-1629
Practice Address - Country:US
Practice Address - Phone:412-831-5155
Practice Address - Fax:412-831-8060
Is Sole Proprietor?:No
Enumeration Date:2006-05-12
Last Update Date:2011-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT004033L225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
0516417OtherAETNA
PA831168OtherHIGHMARK
10897OtherHEALTH AMERICA
10897OtherHEALTH AMERICA