Provider Demographics
NPI:1023213741
Name:CIDILA, JAMIE LINN (MSPT)
Entity type:Individual
Prefix:MR
First Name:JAMIE
Middle Name:LINN
Last Name:CIDILA
Suffix:
Gender:M
Credentials:MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:309 SUNSET BLVD
Mailing Address - Street 2:
Mailing Address - City:HERMITAGE
Mailing Address - State:PA
Mailing Address - Zip Code:16148-3563
Mailing Address - Country:US
Mailing Address - Phone:724-301-2644
Mailing Address - Fax:
Practice Address - Street 1:1899 E STATE ST
Practice Address - Street 2:
Practice Address - City:HERMITAGE
Practice Address - State:PA
Practice Address - Zip Code:16148-1866
Practice Address - Country:US
Practice Address - Phone:724-308-7391
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-21
Last Update Date:2025-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT015299225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
002505925OtherHIGHMARK