Provider Demographics
NPI:1538775408
Name:SEMLER, MICHAEL RYAN (PT, DPT)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:RYAN
Last Name:SEMLER
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:161 STEINWAY AVE
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10314-4819
Mailing Address - Country:US
Mailing Address - Phone:718-551-7107
Mailing Address - Fax:
Practice Address - Street 1:161 STEINWAY AVE
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10314-4819
Practice Address - Country:US
Practice Address - Phone:718-551-7107
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-16
Last Update Date:2020-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA0196500225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist