Provider Demographics
NPI:1952639866
Name:GITZELMANN, CHRISTOPHER ANTHONY (MD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:ANTHONY
Last Name:GITZELMANN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 829642
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19182-9642
Mailing Address - Country:US
Mailing Address - Phone:866-470-6626
Mailing Address - Fax:
Practice Address - Street 1:125 PATERSON ST STE 3300
Practice Address - Street 2:
Practice Address - City:NEW BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08901-1962
Practice Address - Country:US
Practice Address - Phone:732-235-7821
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-12-04
Last Update Date:2021-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2554572086S0120X
NJ25MA104977002086S0120X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0120XAllopathic & Osteopathic PhysiciansSurgeryPediatric Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03171886Medicaid
NYJ400011469Medicare PIN