Provider Demographics
NPI:1164573440
Name:DITUNNO, JOHN F JR (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:F
Last Name:DITUNNO
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:132 S 10TH ST
Mailing Address - Street 2:SUITE 375 MAIN BUILDING
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19107-5244
Mailing Address - Country:US
Mailing Address - Phone:215-955-5580
Mailing Address - Fax:215-955-5152
Practice Address - Street 1:132 S 10TH ST
Practice Address - Street 2:SUITE 375 MAIN BUILDING
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19107-5244
Practice Address - Country:US
Practice Address - Phone:215-955-5580
Practice Address - Fax:215-955-5152
Is Sole Proprietor?:No
Enumeration Date:2007-01-15
Last Update Date:2024-03-23
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Provider Licenses
StateLicense IDTaxonomies
PAMD026630L208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAC27189Medicare UPIN