Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Justin D Ditheodore, PT

Individual provider Physical Therapist · NPI 1073836656

Justin D Ditheodore, PT is a Physical Therapist in Private Practice in Vineland, New Jersey. Qualified in 2009, 17 years ago. Practices with Premier Orthopaedic and Sports Medicine Assoc of Southern Nj LLC, a 36-clinician group and accepts Medicare assignment. Licensed in New Jersey.

Years since qualifying
17
Licensed in
NJ
In the registry since
2010
What do these letters mean?
PT — Physical Therapist
A licensed therapist who treats movement, pain and injury.

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Practice location Address checks out

298 S Delsea Dr
Vineland, NJ 08360-4568
Phone: (856) 690-1616
Fax: (856) 690-1089
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence 40QA01339000 (NJ)

Record details

NPI number1073836656
Entity typeIndividual (Type 1)
GenderMale
Credentials PT
Sole proprietorNo
NPI enumeratedMarch 10, 2010
Last updated in NPPESApril 29, 2020
Certification dateApril 29, 2020
Mailing address352 S Delsea Dr Ste C, Vineland, NJ 08360-5306

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2009 (17 years in practice)
Group practice Premier Orthopaedic And Sports Medicine Assoc Of Southern Nj Llc — 36 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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