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

Nicole Ditullio

Individual provider Physical Therapy Assistant · NPI 1790459691

Nicole Ditullio is a Physical Therapy Assistant in Philadelphia, Pennsylvania. Licensed in Pennsylvania. Registered with an NPI since 2021.

Licensed in
PA
In the registry since
2021

Practice location Address checks out

9896 Bustleton Ave
Philadelphia, PA 19115-5202
Phone: (215) 934-3000
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapy Assistant (primary) Taxonomy 225200000X · Licence TE012823 (PA)

Record details

NPI number1790459691
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedAugust 4, 2021
Last updated in NPPESAugust 4, 2021
Certification dateAugust 4, 2021
Mailing address814 Mountain St, Philadelphia, PA 19148-1207

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