Provider Demographics
NPI:1386720704
Name:KLITZ, DIANA (PT)
Entity type:Individual
Prefix:MRS
First Name:DIANA
Middle Name:
Last Name:KLITZ
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 STITES AVE
Mailing Address - Street 2:
Mailing Address - City:CAPE MAY COURT HOUSE
Mailing Address - State:NJ
Mailing Address - Zip Code:08210-2267
Mailing Address - Country:US
Mailing Address - Phone:609-927-1991
Mailing Address - Fax:609-926-0075
Practice Address - Street 1:9 STITES AVE
Practice Address - Street 2:
Practice Address - City:CAPE MAY COURT HOUSE
Practice Address - State:NJ
Practice Address - Zip Code:08210-2267
Practice Address - Country:US
Practice Address - Phone:609-927-1991
Practice Address - Fax:609-926-0075
Is Sole Proprietor?:No
Enumeration Date:2006-10-27
Last Update Date:2023-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01224000225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist