Provider Demographics
NPI:1912020322
Name:CITTA, THELMA JEAN (DO)
Entity Type:Individual
Prefix:DR
First Name:THELMA
Middle Name:JEAN
Last Name:CITTA
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:THELMA
Other - Middle Name:JEAN
Other - Last Name:CITTA-PIETROLUNGO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:1175 MARLKRESS RD
Mailing Address - Street 2:#4353
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08034-9998
Mailing Address - Country:US
Mailing Address - Phone:856-630-6000
Mailing Address - Fax:856-250-0777
Practice Address - Street 1:1100 LIBERTY PL
Practice Address - Street 2:
Practice Address - City:SICKLERVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08081-5708
Practice Address - Country:US
Practice Address - Phone:856-630-6000
Practice Address - Fax:856-250-0777
Is Sole Proprietor?:No
Enumeration Date:2007-04-09
Last Update Date:2023-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MB054779002081P0010X, 208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
No2081P0010XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPediatric Rehabilitation Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ047239Medicare ID - Type Unspecified
NJE77455Medicare UPIN